Among intermediate-risk patients with severe aortic stenosis(AS),trans-catheter aortic-valve replacement(TAVR)and conventional aortic-valve replacement provide similar outcomes. However, data are missing to compare Rapid-deployment aortic-valve replacement(RDAVR)and TAVR.

We compare the 1year outcomes of RDAVR with INTUITY and TAVR with SAPIEN 3 in intermediate-risk patients.

Inclusion criteria: severe symptomatic aortic stenosis implanted with TAVR or RDAVR; intermediate risk defined with 4≤EUROSCORE2≤10. Regression adjustment for the propensity score was used to compare RDAVR patients with TAVR patients. Patients follow-up was 2years. Primary endpoints: composite of death, stroke, or rehospitalization. Secondary endpoints: occurrence of major bleeding complication, paravalvular regurgitation≥grade 1(PVR), patient-prosthesis mismatch (PPM)and pacemaker implantation.

A total of 152 patients were included from September 2012 to April 2017:104 in the TAVR group and 48 in the RDAVR group. Mean age was 82,7±6, 48.7% male, mean Euroscore II was 6.03±1.6% and mean baseline LVEF was 56±13%,mean indexed AVA was 0.41±0.1cm/m², mean gradient was 51.7±14.7mmHg. Patients with RDAVR were younger(79,5±6 vs. 84,2±6, P<0.01), at higher risk (6,61±1,8% vs. 5,76±1,5%, P=0.0027),with combined surgery in 28patients (58.3%). Primary endpoint was similar between RDAVR and TAVR at 1year (0.66; [0.34–1.26]; P=0.21) but significantly different at 2 years (0.58; [0.34–1,00]; P=0.048). There were no significant difference between both group in death(0.54;[0.09–2.44]; P=0.43), or rehospitalization (0.60; [0.30–1.20]; P=0.14). No stroke occurs. No difference were observed in PPM occurrence (0,83;[0.35–1.94]; P=0.67), major bleeding event (1.33; [0.47–3.93]; P=0.59), PVR (0,71;[0.29–1.73]; P=0.46), and pacemaker implantation (11.5% vs. 8.3%, P=0.77).

RDAVR with INTUITY provides similar 1year outcomes and better 2years outcomes than TAVR with SAPIEN3 despite a higher EUROSCORE2 and more combined surgery.