Latest results from the PARTNER 3 trial, comparing transcatheter aortic valve implantation (TAVI) to surgical aortic valve replacement in low surgical risk patients with severe, symptomatic aortic stenosis, have shown no significant differences between the two treatments in rates of death, stroke and rehospitalisation at seven years.
The trial randomised 1,000 patients with severe symptomatic aortic stenosis between March 2016 and October 217 to undergo TAVI using the Sapien 3 balloon-expandable valve (n=503) or surgery (n=497) for severe aortic stenosis.
The trial’s results at one and two years demonstrated superior or similar results for TAVI for the primary endpoints of death, stroke or rehospitalisation. Five-year data showed an attenuation in the differences in events between the two groups, Michael Mack (Baylor Scott & White Health, Plano, USA) said in his presentation of the results at the 2025 Transcatheter Cardiovascular Therapeutics (TCT) conference (25–28 October, San Francisco, USA), a trend he showed had continued at seven years.
The results, also published in the New England Journal of Medicine, showed that the primary endpoint—a hierarchical composite of death, disabling stroke, non-disabling stroke, and valve-related rehospitalisation—occurred in 34.6% of the trial’s TAVI patients, and 37.2% of those who underwent surgery. In the TAVI and surgery groups, respectively, Kaplan–Meier estimates for the incidence of components of the first primary endpoint were: death, 19.5% and 16.8%; stroke, 8.5% and 8.1%; and rehospitalisation, 20.6% and 23.5%.
At seven years, the data showed statistically comparable long-term valve performance between TAVI and SAVR. Valve durability indicators remained stable over time, with no difference in bioprosthetic valve failure (6.9% vs. 7.3%) or reintervention rates (6% vs. 6.7%). Both all-cause and cardiovascular mortality rates were similar between cohorts. Significant improvements in health status and quality of life after treatment with TAVI and SAVR were sustained.
