Valvular & structural heart disease

5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis

J Am Coll CardiolPublished Randomised controlled trial

Authors' conclusion

At 5 years, patients with severe aortic stenosis who were treated with either TAVR or surgery had comparable rates of all-cause mortality or disabling stroke.

Study context

Population
Low-risk patients with severe AS (Evolut Low Risk trial)attempted implant
Participants
1,414 patients
Comparison
Transcatheter aortic valve replacement (TAVR) vs surgery
  • TAVRn = 730
  • Surgeryn = 684reference
Primary endpoint
All-cause mortality or disabling stroke
Follow-up
5 years

Primary result

As reported in the abstract

All-cause mortality or disabling stroke (Kaplan-Meier estimate)

P = 0.47

Secondary outcomes

All-cause mortality (Kaplan-Meier estimate) · 5 years

P = 0.39

Disabling stroke (Kaplan-Meier estimate) · 5 years

P = 0.57

CV mortality · 5 years

P = 0.15

Non-CV mortality · 5 years

P = 0.73

All-cause mortality incl. site-level vital status sweep of patients lost to follow-up or withdrawn · 5 years

P = 0.74

Valve reintervention · 5 years

P = 0.44

Mean

OutcomeTAVRSurgery
Kansas City Cardiomyopathy Questionnaire summary score · 5 yearsSustained improvement in QoL in both arms88.3 (SD 15.8)88.5 (SD 15.8)

Original publication

5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis. J Am Coll Cardiol. Published 30 March 2025. doi:10.1016/j.jacc.2025.03.004

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