{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:43:11Z","timestamp":1790289791585,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"NIH NHLBI","award":["#2UM1 HL088925"],"award-info":[{"award-number":["#2UM1 HL088925"]}]},{"name":"NIH NIGMS","award":["#5U54GM104942-05"],"award-info":[{"award-number":["#5U54GM104942-05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Recent data suggest that 50% of patients \u226465 years of age undergo transcatheter aortic valve implantation (TAVI). It has also been suggested that these patients are typically high risk with poor life expectancy. We sought to evaluate predicted risk, procedural and longitudinal outcomes, and cost in patients \u226465 years who received TAVI in the Premier Healthcare Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients aged 65 and younger receiving TAVI (2017-2024) were assessed. A predicted risk of index surgical aortic valve mortality model, incorporating the Fried frailty index, was fitted to simulate the Society of Thoracic Surgeons risk model (AUC\u2009=\u20090.850). TAVI outcomes were stratified by predicted risk of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A cohort of 6921 patients \u226465 years received TAVI. The median age was 60 years, 81.3% were elective, and 9.1% bicuspid. The average predicted risk was 4.3%, with 66.2% of patients having a predicted risk &amp;lt;4%. A total of 50 patients (0.7%) died within 30 days of the index procedure. Early complications included 41 (0.6%) emergent sternotomies, 182 (2.6%) unplanned coronary interventions, 32 (0.5%) femoral artery repairs, 77 (1.0%) strokes, and 485 (4.1%) new permanent pacemakers. With a median follow-up of 3.3 years, 5-year survival was 88% in low- and intermediate-risk patients and 78% in the high-risk cohort (&amp;gt;8% predicted).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most contemporary patients \u226465 years receiving TAVI outside of existing guidelines are of low surgical risk. These findings, in combination with the cumulative longitudinal risks of TAVI, highlight the need for careful heart team discussions for most young patients requiring AVR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag103","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:38:54Z","timestamp":1771418334000},"source":"Crossref","is-referenced-by-count":2,"title":["Young Transcatheter Aortic Valve Implantation: Shifting Risk and Outcomes"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-7737","authenticated-orcid":false,"given":"J Hunter","family":"Mehaffey","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University , Morgantown, WV 26501,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikrant","family":"Jagadeesan","sequence":"additional","affiliation":[{"name":"Department of 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