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

Troels Højsgaard Jørgensen; Hans Gustav Hørsted Thyregod; Stefan Blankenberg; Martin Leon; Lars Sondergaard; Bernard Prendergast; Ole De Backer

doi:10.1016/j.ahj.2025.07.070

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

Troels Højsgaard Jørgensen, Hans Gustav Hørsted Thyregod, Stefan Blankenberg, Martin Leon, Lars Sondergaard, Bernard Prendergast, Ole De Backer^*

^*Corresponding author for this work

Abstract

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.

Original language	English
Journal	American Heart Journal
Volume	291
Pages (from-to)	10-13
Number of pages	4
ISSN	0002-8703
DOIs	https://doi.org/10.1016/j.ahj.2025.07.070
Publication status	Published - Jan 2026

Keywords

Humans
Transcatheter Aortic Valve Replacement/methods
Aortic Valve Stenosis/surgery
Aortic Valve/surgery
Randomized Controlled Trials as Topic
Risk Assessment
Stroke/epidemiology

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10.1016/j.ahj.2025.07.070Licence: CC BY

Cite this

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title = "The Low-Risk TAVR Trials - A Critical Appraisal of the Current Landscape",

abstract = "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.",

keywords = "Humans, Transcatheter Aortic Valve Replacement/methods, Aortic Valve Stenosis/surgery, Aortic Valve/surgery, Randomized Controlled Trials as Topic, Risk Assessment, Stroke/epidemiology",

author = "J{\o}rgensen, \{Troels H{\o}jsgaard\} and Thyregod, \{Hans Gustav H{\o}rsted\} and Stefan Blankenberg and Martin Leon and Lars Sondergaard and Bernard Prendergast and \{De Backer\}, Ole",

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year = "2026",

month = jan,

doi = "10.1016/j.ahj.2025.07.070",

language = "English",

volume = "291",

pages = "10--13",

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AU - Jørgensen, Troels Højsgaard

AU - Thyregod, Hans Gustav Hørsted

AU - Blankenberg, Stefan

AU - Leon, Martin

AU - Sondergaard, Lars

AU - Prendergast, Bernard

AU - De Backer, Ole

PY - 2026/1

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N2 - 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.

AB - 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.

KW - Humans

KW - Transcatheter Aortic Valve Replacement/methods

KW - Aortic Valve Stenosis/surgery

KW - Aortic Valve/surgery

KW - Randomized Controlled Trials as Topic

KW - Risk Assessment

KW - Stroke/epidemiology

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JO - American Heart Journal

JF - American Heart Journal

ER -

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

Abstract

Keywords

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