Author + information
- Hans Gustav Hørsted Thyregod, MD∗ (, )
- Daniel Andreas Steinbrüchel, MD, DMSc and
- Lars Søndergaard, MD, DMSc
- ↵∗Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
In the NOTION (Nordic Aortic Valve Intervention) trial (1), we included all eligible patients with stand-alone severe aortic valve stenosis. This resulted in a patient population with a mean Society of Thoracic Surgeons Predicted Risk of Mortality score of 3.0% and 82% considered at low surgical mortality risk (a score lower than 4%). The 2 other randomized trials comparing transcatheter aortic valve replacement versus surgical aortic valve replacement included high-risk patients with a mean Society of Thoracic Surgeons Predicted Risk of Mortality score of 11.7% (2) and 7.4% (3). As noted by Drs. Gravel and Généreux, the outcomes of our trial could potentially be driven by outcomes primarily in intermediate- and high-risk patients, constituting 18% of the sample size, and would therefore not reflect results for true low-risk patients. However, this was not what we found as will be demonstrated in an upcoming publication of the NOTION trial 2-year results.
Please note: Dr. Søndergaard is a proctor for Medtronic, Inc; he has been involved in research contracts with St. Jude Medical, Inc.; and he received speakers fees from Medtronic, Inc. Drs. Søndergaard and Steinbrüchel have been involved in research contracts with Medtronic, Inc. Dr. Thyregod has reported that he has no relationships relevant to the contents of this paper to disclose.
- 2015 American College of Cardiology Foundation