The Low-Risk TAVR Trials - A Critical Appraisal of the Current Landscape

The low-risk TAVR vs SAVR RCTs - PARTNER-3, Evolut Low-Risk, DEDICATE, and NOTION-2 - demonstrate that TAVR is at least as effective as SAVR in terms of early mortality and disabling stroke, although outcomes varied across studies. The excellent outcomes observed in the PARTNER-3 trial reflect the highly selected patient population, while the NOTION-2 trial highlights the challenges posed by anatomical variations, such as bicuspid aortic valves (AV). These findings highlight the importance of a personalized approach guided by a multidisciplinary Heart Team, taking into account both clinical and anatomical aspects when choosing between TAVR and SAVR. Trial registration number: ClinicalTrials.gov NCT02825134.