{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:01:05Z","timestamp":1789689665212,"version":"4.0.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis, but data are limited on younger, low-risk patients. This analysis compares outcomes in low-surgical-risk patients aged &lt;75 years receiving TAVR versus surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>The Evolut Low Risk Trial randomized 1414 low-risk patients to treatment with a supra-annular, self-expanding TAVR or surgery. We compared rates of all-cause mortality or disabling stroke, associated clinical outcomes, and bioprosthetic valve performance at 3 years between TAVR and surgery patients aged &lt;75 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              In patients &lt;75 years, 352 were randomized to TAVR and 351 to surgery. Mean age was 69.1\u00b14.0 years (minimum 51 and maximum 74); Society of Thoracic Surgeons Predicted Risk of Mortality was 1.7\u00b10.6%. At 3 years, all-cause mortality or disabling stroke for TAVR was 5.7% and 8.0% for surgery (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.241). Although there was no difference between TAVR and surgery in all-cause mortality, the incidence of disabling stroke was lower with TAVR (0.6%) than surgery (2.9%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.019), while surgery was associated with a lower incidence of pacemaker implantation (7.1%) compared with TAVR (21.0%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). Valve reintervention rates (TAVR 1.5%, surgery 1.5%,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.962) were low in both groups. Valve performance was significantly better with TAVR than surgery with lower mean aortic gradients (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and lower rates of severe prosthesis-patient mismatch (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). Rates of valve thrombosis and endocarditis were similar between groups. There were no significant differences in rates of residual \u2265moderate paravalvular regurgitation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Low-risk patients &lt;75 years treated with supra-annular, self-expanding TAVR had comparable 3-year all-cause mortality and lower disabling stroke compared with patients treated with surgery. There was significantly better valve performance in patients treated with TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02701283.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.124.014018","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T09:01:12Z","timestamp":1729242072000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Three-Year Outcomes Following TAVR in Younger (&lt;75 Years) Low-Surgical-Risk Severe Aortic Stenosis Patients"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct02701283","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4169-3766","authenticated-orcid":true,"given":"Thomas","family":"Modine","sequence":"first","affiliation":[{"name":"Centre Hospitalier Universitaire de Bordeaux, L\u2019Unit\u00e9 M\u00e9dico-Chirurgicale des Valvulopathies, Chirurgie Cardiaque, Universit\u00e9 de Bordeaux, France (T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7243-9408","authenticated-orcid":true,"given":"Didier","family":"Tch\u00e9tch\u00e9","sequence":"additional","affiliation":[{"name":"Clinique Pasteur, Toulouse, France (D.T., P.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2732-1205","authenticated-orcid":true,"given":"Nicolas M.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, the Netherlands (N.M.V.M., R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4698-2789","authenticated-orcid":true,"given":"G. Michael","family":"Deeb","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Division of Interventional Cardiology (G.M.D.), Michigan Medicine Health Systems \u2013 University Hospital, Ann Arbor, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley J.","family":"Chetcuti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Division of Cardiovascular Medicine (S.J.C.), Michigan Medicine Health Systems \u2013 University Hospital, Ann Arbor, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Yakubov","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ohio Health Riverside Methodist Hospital, Columbus (S.J.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6401-854X","authenticated-orcid":true,"given":"Paul","family":"Sorajja","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, MN (P.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemal","family":"Gada","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Cardiothoracic Surgery, University of Pittsburgh Medical Center, Moffitt Heart\/Pinnacle Health, Harrisburg, PA (H.G., M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8348-9336","authenticated-orcid":true,"given":"Mubashir","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Cardiothoracic Surgery, University of Pittsburgh Medical Center, Moffitt Heart\/Pinnacle Health, Harrisburg, PA (H.G., M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0471-0910","authenticated-orcid":true,"given":"Basel","family":"Ramlawi","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Lankenau Heart Institute, Wynnewood, PA (B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0720-0879","authenticated-orcid":true,"given":"Tanvir","family":"Bajwa","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Cardiothoracic Surgery, Aurora Health Care, Aurora St. Luke\u2019s Medical Center, Milwaukee, WI (T.B., J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5020-6203","authenticated-orcid":true,"given":"John","family":"Crouch","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Cardiothoracic Surgery, Aurora Health Care, Aurora St. Luke\u2019s Medical Center, Milwaukee, WI (T.B., J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Teirstein","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Scripps Clinic, Scripps Prebys Cardiovascular Institute, La Jolla, CA (P.S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-8133","authenticated-orcid":true,"given":"Neal S.","family":"Kleiman","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology and Cardiothoracic Surgery, Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (N.S.K., M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Iskander","sequence":"additional","affiliation":[{"name":"Saint Joseph\u2019s Hospital Health Center, Syracuse, NY (A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-9429","authenticated-orcid":true,"given":"Rodrigo","family":"Bagur","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre \u2013 University Campus, Ontario, Canada (R.B., 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(A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1001-8840","authenticated-orcid":true,"given":"Rik","family":"Adrichem","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, the Netherlands (N.M.V.M., R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-2340","authenticated-orcid":true,"given":"Saki","family":"Ito","sequence":"additional","affiliation":[{"name":"Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN (S.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Medtronic, Mounds View, MN (J.H., J.J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Popma","sequence":"additional","affiliation":[{"name":"Medtronic, Mounds View, MN (J.H., 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