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Valvular & structural heart diseaseSecondary analysis

Seven-Year Valve Durability With Transcatheter or Surgical Aortic Valve Replacement

JAMA CardiolPublished

  • Secondary analysis of a randomised controlled trial
  • ad hoc analysis
  • multicentre

537 of 671 alive patients (80.0%) had echocardiographic analysis at 7 years

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Authors' conclusion

In this ad hoc analysis of a randomized clinical trial among low-risk patients with symptomatic severe aortic stenosis randomized to TAVR or surgery, both TAVR and surgery demonstrated comparable and sustained valve durability, with low and similar rates of SVD, all-cause BVF, and reintervention through 7 years.

Study context

Population
Low-risk patients with symptomatic severe AS, 71 centres in the US and Canada, enrolled March 2016–October 2017randomised
Participants
1,000 patients
Comparison
Transcatheter aortic valve replacement (TAVR) vs surgery
  • TAVRn = 495
  • Surgeryn = 453reference
Primary endpoint
Stage 2 or 3 BVD related to SVD, thrombosis or endocarditis; all-cause BVF; SVD-related BVF; aortic valve reintervention (cumulative incidence, death as competing risk)
Follow-up
7 years

Primary result

As reported in the abstract

TAVR

7.3%

Stage 2 or 3 Structural Valve Deterioration (SVD)-related Bioprosthetic Valve Dysfunction (BVD) · All-cause Bioprosthetic Valve Failure (BVF) 6.9% · SVD-related BVF 3.9% · Valve reintervention 6.0% · Stage 2 or 3 thrombosis-related BVD 5.2% · Stage 2 or 3 endocarditis-related BVD 0.4%

Surgery

7.6%

Stage 2 or 3 SVD-related BVD · All-cause BVF 7.5% · SVD-related BVF 5.3% · Valve reintervention 5.5% · Stage 2 or 3 thrombosis-related BVD 0.9% · Stage 2 or 3 endocarditis-related BVD 0.5%

TAVR vs SurgeryHazard ratio (95% CI)P value
stage 2 or 3 SVD-related BVD
0.96(0.59–1.57)
P = 0.88
all-cause BVF
0.91(0.55–1.49)
P = 0.69
SVD-related BVF
0.72(0.39–1.36)
P = 0.31
valve reintervention
1.09(0.62–1.90)
P = 0.77
stage 2 or 3 thrombosis-related BVD; most events within 3 years, few progressed to BVF
5.52(1.92–15.85)
P < 0.001
stage 2 or 3 endocarditis-related BVD
0.85(0.12–6.07)
P = 0.87

Further findings

Alive and free of all-cause BVF · 7 years

P = 0.69

Original publication

Seven-Year Valve Durability With Transcatheter or Surgical Aortic Valve Replacement. JAMA Cardiol. Published 1 August 2026. doi:10.1001/jamacardio.2026.2299
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Summarised from the published abstract; every number is checked against it