Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement

This multicenter randomized trial assessed long-term outcomes of transcatheter aortic-valve replacement (TAVR) versus surgical aortic-valve replacement (SAVR) in 2,032 intermediate-risk patients with severe aortic stenosis. At 5 years, no significant difference was found between groups in rates of death or disabling stroke. However, TAVR was associated with higher rates of paravalvular regurgitation, repeat hospitalizations, and valve reintervention. Functional and quality-of-life improvements were similar between groups. Outcomes varied by access route, with transthoracic TAVR performing worse than SAVR. Findings suggest comparable survival outcomes between TAVR and SAVR, with trade-offs in complications and valve durability.

This multicenter randomized trial assessed long-term outcomes of transcatheter aortic-valve replacement (TAVR) versus surgical aortic-valve replacement (SAVR) in 2,032 intermediate-risk patients with severe aortic stenosis. At 5 years, no significant difference was found between groups in rates of death or disabling stroke. However, TAVR was associated with higher rates of paravalvular regurgitation, repeat hospitalizations, and valve reintervention. Functional and quality-of-life improvements were similar between groups. Outcomes varied by access route, with transthoracic TAVR performing worse than SAVR. Findings suggest comparable survival outcomes between TAVR and SAVR, with trade-offs in complications and valve durability.