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<p>The Randomized researcH in womEn all comers wIth Aortic stenosis (RHEIA) trial is the first randomized study to compare transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) exclusively in low-risk women with severe aortic stenosis. While results showed statistical superiority of TAVI for the composite endpoint of death, stroke, or rehospitalization at 1&#xa0;year, this was driven primarily by reduced readmission rates. Mortality and stroke outcomes were similar between groups. Significant procedural imbalances and reliance on as-treated analysis raise concerns about interpretation. RHEIA not only fills a critical evidence gap in sex-specific valve therapy but also highlights persistent methodological challenges in evaluating treatment efficacy in this population.</p>

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New packaging, old ingredients: what the RHEIA Trial really tells us about TAVI in women?

  • 期刊论文

  • 发表日期：

    2025年8月21日

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  • Pradeep Narayan

摘要

The Randomized researcH in womEn all comers wIth Aortic stenosis (RHEIA) trial is the first randomized study to compare transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) exclusively in low-risk women with severe aortic stenosis. While results showed statistical superiority of TAVI for the composite endpoint of death, stroke, or rehospitalization at 1 year, this was driven primarily by reduced readmission rates. Mortality and stroke outcomes were similar between groups. Significant procedural imbalances and reliance on as-treated analysis raise concerns about interpretation. RHEIA not only fills a critical evidence gap in sex-specific valve therapy but also highlights persistent methodological challenges in evaluating treatment efficacy in this population.