{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:58:41Z","timestamp":1784991521018,"version":"3.55.0"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>It remains unknown whether outcomes of the Placement of Aortic Transcatheter Valves 3 (PARTNER 3) and Evolut Low Risk trials are comparable with surgical outcomes in nontrial settings, considering the added risk of concomitant cardiac operations.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare 30-day mortality and stroke incidences of patients in the surgical aortic valve replacement (SAVR) arm of low-risk trials with those of similar patients in the US Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>A cross-sectional sampling study was conducted of adults in the STS ACSD with severe aortic stenosis at low surgical risk for AVR who underwent SAVR during the years low-risk AVR trials (PARTNER 3 and Evolut Low Risk) were enrolling (calendar years 2016-2018). After trial exclusion criteria were applied, 1000 samples were created, each including 1000 patients selected from the STS ACSD according to the likelihood-based selection probabilities to achieve similar STS predicted risk of mortality (PROM) distribution to the trial participants. The distribution of 30-day mortality and stroke rates among these samples were compared with the results from the trials. The analysis was conducted between October 2, 2023, and May 27, 2024.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcomes were 30-day postoperative mortality and stroke.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 25\u202f811 patients at low risk undergoing SAVR, the mean (SD) age was 71 (7) years, including 650\u202f220 men (65%). The probability-based sampling yielded a trial-like sample with STS PROM (mean [SD], 1.9% [0.6%]) and concomitant coronary artery bypass graft surgery frequencies of 13%, comparable with the trials. Among the sampled cohorts, the mean (SD) 30-day mortality rate was 1.39% (0.38%) which was not significantly different from the mortality rate in PARTNER 3 (1.1%) (P<\/jats:italic>\u2009=\u2009.83) and Evolut Low Risk (1.3%) (P<\/jats:italic>\u2009=\u2009.65). The stroke rate was 1.25% (0.36%), significantly lower than PARTNER 3 (2.4%) (P<\/jats:italic>\u2009=\u2009.002) and Evolut Low Risk (3.4%) (P<\/jats:italic>\u2009&amp;lt;\u2009.001).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cross-sectional study, the national samples of low-risk trial-like patients undergoing SAVR during the trial enrollment period had similar 30-day mortality but a lower incidence of stroke compared with the SAVR arm of both low-risk trials. These findings overall suggest that the low-risk trial findings may be generalizable to the broader national SAVR cohort.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.53267","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T16:01:24Z","timestamp":1736179284000},"page":"e2453267","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Outcomes Between Low-Risk Aortic Valve Replacement Trials and a Surgical Registry"],"prefix":"10.1001","volume":"8","author":[{"given":"Makoto","family":"Mori","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut"},{"name":"Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Shioda","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Center on Emerging Infectious Diseases, Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Waldron","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Huang","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"George","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic and Vascular Surgery, Columbia University Irving 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