{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:39:21Z","timestamp":1771511961794,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,4,11]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate whether transcatheter or surgical aortic valve replacement (TAVR or SAVR) affects clinical and haemodynamic outcomes in symptomatic patients with moderately-severe aortic stenosis (AS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Echocardiographic evidence of severe AS for enrolment in the Evolut Low Risk trial was based on site-reported measurements. For this post hoc analysis, core laboratory measurements identified patients with symptomatic moderately-severe AS (1.0&lt;aortic valve area (AVA)&lt;1.5\u2009cm<jats:sup>2<\/jats:sup>, 3.0&lt;peak velocity&lt;4.0 m\/s and 20\u2264mean gradient (MG) &lt;40\u2009mm Hg). Clinical outcomes were reported through 2 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Moderately-severe AS was identified in 113 out of 1414 patients (8%). Baseline AVA was 1.1\u00b10.1\u2009cm<jats:sup>2<\/jats:sup>, peak velocity 3.7\u00b10.2 m\/s, MG 32.7\u00b14.8\u2009mm Hg and aortic valve calcium volume 588 (364, 815) mm<jats:sup>3<\/jats:sup>. Valve haemodynamics improved following TAVR (AVA 2.5\u00b10.7\u2009cm<jats:sup>2<\/jats:sup>, peak velocity 1.9\u00b10.5 m\/s and MG 8.4\u00b14.8\u2009mm Hg; p&lt;0.001 for all) and SAVR (AVA 2.0\u00b10.6\u2009cm<jats:sup>2<\/jats:sup>, peak velocity 2.1\u00b10.4 m\/s and MG 10.0\u00b13.4\u2009mm Hg; p&lt;0.001 for all). At 24 months, the rates of death or disabling stroke were similar (TAVR 7.7% vs SAVR 6.5%; p=0.82). Kansas City Cardiomyopathy Questionnaire overall summary score assessing quality of life improved from baseline to 30 days after TAVR (67.0\u00b120.6\u2009to 89.3\u00b113.4; p&lt;0.001) and SAVR (67.5\u00b119.6\u2009to 78.3\u00b122.3; p=0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In symptomatic patients with moderately-severe AS, AVR appears to be beneficial. Determination of the clinical and haemodynamic profile of patients who can benefit from earlier isolated AVR needs further investigation in randomised clinical trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002297","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T09:55:14Z","timestamp":1683885314000},"page":"e002297","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of aortic valve replacement in symptomatic low-risk patients with less than severe aortic stenosis"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02701283","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02661451","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04889872","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05149755","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-2340","authenticated-orcid":false,"given":"Saki","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Laham","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vuyisile T","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John K","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Cardiology), Yale-New Haven Hospital, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J","family":"Reardon","sequence":"additional","affiliation":[{"name":"Departments of Cardiology and Cardiothoracic Surgery, Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen H","family":"Little","sequence":"additional","affiliation":[{"name":"Departments of Cardiology and Cardiothoracic Surgery, Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mubashir","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Departments of Cardiothoracic Surgery and Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle Health, Wormsleyburg, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemal","family":"Gada","sequence":"additional","affiliation":[{"name":"Departments of Cardiothoracic Surgery and Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle Health, Wormsleyburg, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanvir","family":"Bajwa","sequence":"additional","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services, Aurora Saint Luke\u2019s Medical Center, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Langholz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Heiser","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atul","family":"Chawla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mercy Medical Center, IA, Mercy Medical Center, Des Moines, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Jenson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mercy Medical Center, IA, Mercy Medical Center, Des Moines, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme","family":"Attizanni","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H","family":"Markowitz","sequence":"additional","affiliation":[{"name":"Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Structural Heart and Aortic, Medtronic Inc, Mounds View, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae K","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 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