{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:30:29Z","timestamp":1793759429765,"version":"4.6.1"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:sec id=\"ab-hoi240070-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Guidelines advise heart team assessment for all patients with aortic stenosis, with surgical aortic valve replacement recommended for patients younger than 65 years or with a life expectancy greater than 20 years. If bioprosthetic valves are selected, repeat procedures may be needed given limited durability of tissue valves; however, younger patients with aortic stenosis may have major comorbidities that can limit life expectancy, impacting decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize patients younger than 65 years who received transcatheter aortic valve replacement (TAVR) and compare their outcomes with patients aged 65 to 80 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This retrospective registry-based analysis used data on 139\u202f695 patients from the Society for Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry, inclusive of patients 80 years and younger undergoing TAVR from August 2019 to September 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-7\">\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Balloon-expandable valve (BEV) TAVR with the SAPIEN family of devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Comorbidities (heart failure, coronary artery disease, dialysis, and others) and outcomes (death, stroke, and hospital readmission) of patients younger than 65 years compared to patients aged 65 to 80 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the years surveyed, 13\u202f849 registry patients (5.7%) were younger than 65 years, 125\u202f846 (52.1%) were aged 65 to 80 years, and 101\u202f725 (42.1%) were 80 years and older. Among those younger than 65, the mean (SD) age was 59.7 (4.8) years, and 9068 of 13\u202f849 patients (65.5%) were male. Among those aged 65 to 80 years, the mean (SD) age was 74.1 (4.2) years, and 77\u202f817 of 125\u202f843 patients (61.8%) were male. Those younger than 65 years were more likely to have a bicuspid aortic valve than those aged 65 to 80 years (3472\/13\u202f755 [25.2%] vs 9552\/125\u202f001 [7.6%], respectively;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). They were more likely to have congestive heart failure, chronic lung disease, diabetes, immunocompromise, and end stage kidney disease receiving dialysis. Patients younger than 65 years had worse baseline quality of life (mean [SD] Kansas City Cardiomyopathy Questionnaire score, 47.7 [26.3] vs 52.9 [25.8], respectively;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) and mean (SD) gait speed (5-meter walk test, 6.6 [5.8] seconds vs 7.0 [4.9] seconds, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) than those aged 65 to 80 years. At 1 year, patients younger than 65 years had significantly higher readmission rates (2740 [28.2%] vs 23\u202f178 [26.1%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) and all-cause mortality (908 [9.9%] vs 6877 [8.2%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) than older patients. When propensity matched, younger patients still had higher 1-year readmission rates (2732 [28.2%] vs 2589 [26.8%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.03) with similar mortality to their older counterparts (905 [9.9%] vs 827 [10.1%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.55).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240070-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Among US patients receiving BEV TAVR for severe aortic stenosis in the low\u2013surgical risk era, those younger than 65 years represent a small subset. Patients younger than 65 years had a high burden of comorbidities and incurred higher rates of death and readmission at 1 year compared to their older counterparts. These observations suggest that heart team decision-making regarding TAVR for most patients in this age group is clinically valid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2024.4237","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T09:31:49Z","timestamp":1730280709000},"page":"127","source":"Crossref","is-referenced-by-count":46,"title":["Outcomes of Balloon-Expandable Transcatheter Aortic Valve Replacement in Younger Patients in the Low-Risk Era"],"prefix":"10.1001","volume":"10","author":[{"given":"Megan","family":"Coylewright","sequence":"first","affiliation":[{"name":"University of Tennessee Health Science Center, Chattanooga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra J.","family":"Grubb","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne V.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Batchelor","sequence":"additional","affiliation":[{"name":"Inova Schar Heart and Vascular, Falls Church, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijeet","family":"Dhoble","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Aaron","family":"Horne","sequence":"additional","affiliation":[{"name":"Summit Health, Berkeley Heights, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin B.","family":"Leon","sequence":"additional","affiliation":[{"name":"New York-Presbyterian Hospital\/Columbia University Irving Medical Center, New York"},{"name":"Cardiovascular Research Foundation, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Thourani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamim M.","family":"Nazif","sequence":"additional","affiliation":[{"name":"New York-Presbyterian Hospital\/Columbia University Irving Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Lindman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Szerlip","sequence":"additional","affiliation":[{"name":"Baylor Scott and White The Heart Hospital, Plano, 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