Diagnosing and deciding how best to treat severe aortic valve stenosis is a critical challenge, especially as the number of affected patients grows with age. Clinicians have long relied on open-heart surgery as the standard of care, while transcatheter aortic valve replacement (TAVR) has emerged as a less invasive alternative. A new clinical trial analysis now shows that long-term outcomes for patients receiving TAVR are comparable to those who undergo surgery, offering meaningful clarity for treatment planning.

In the study by Cedars-Sinai (Los Angeles, California, USA) in collaboration with international research partners, investigators evaluated results from the Phase III PARTNER 3 trial, a large, multicenter study examining long-term outcomes in patients with severe aortic valve stenosis. The research focused on a comparison between TAVR and open-heart surgical valve replacement.

All participants in the trial received the same commercially available bioprosthetic valve—the SAPIEN 3 valve—ensuring consistent device performance across groups. In TAVR, an interventional cardiologist threads a catheter through an artery to replace the narrowed valve, offering a minimally invasive option. Previous trials found similar results up to five years after treatment, but long-term data remained limited.

The PARTNER 3 trial included 1,000 patients across 71 medical centers, all considered to be at low surgical risk. Participants were randomly assigned to either TAVR or surgery. Seven years after treatment, composite rates of death, stroke, or rehospitalization were 34.6% for TAVR and 37.2% for surgery—a difference not statistically significant. Bioprosthetic valve failure rates were also comparable, at 6.9% for TAVR and 7.3% for surgery.

Quality-of-life assessments similarly showed no meaningful differences between the two groups. These findings, published in The New England Journal of Medicine, provide clinicians with a clearer understanding of how the two treatment approaches measure up over time. The investigators plan to continue monitoring patient outcomes and valve durability, with 10-year results expected next.

“These results show that seven years after treatment, health outcomes for patients were similar whether they underwent a minimally invasive procedure or open-heart surgery,” said Raj Makkar, MD, senior author of the study.

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