{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:46:29Z","timestamp":1782413189772,"version":"3.54.5"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,10,21]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The long-term outcomes of transcatheter aortic valve replacement (TAVR) in inoperable patients with severe aortic stenosis remain unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              In the Placement of Aortic Transcatheter Valves (PARTNER) study, 358 patients were randomly assigned to TAVR or standard therapy. We report the 3-year outcomes on these patients, and the pooled outcomes for all randomly assigned inoperable patients (n=449) in PARTNER, as well, including the randomized portion of the continued access study (n=91). The 3-year mortality rate in the TAVR and standard therapy groups was 54.1% and 80.9%, respectively (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; hazard ratio, 0.53; 95% confidence interval, 0.41\u20130.68;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In survivors, there was significant improvement in New York Heart Association functional class sustained at 3 years. The cumulative incidence of strokes at 3-year follow-up was 15.7% in TAVR patients versus 5.5% in patients undergoing standard therapy (hazard ratio, 2.81; 95% confidence interval, 1.26\u20136.26;\n              <jats:italic>P<\/jats:italic>\n              =0.012); however, the composite of death or strokes was significantly lower after TAVR versus standard therapy (57.4% versus 80.9%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001;\n            <\/jats:p>\n            <jats:p>\n              hazard ratio, 0.60; 95% confidence interval, 0.46\u20130.77;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Echocardiography showed a sustained increase in aortic valve area and decrease in transvalvular gradient after TAVR. Analysis of the 449 pooled randomly assigned patients (TAVR, n=220; standard therapy, n=229) demonstrated significant improvement in all-cause mortality and functional status during early and 3-year follow-up. The results of the pooled cohort were similar to the results obtained from the pivotal PARTNER trial.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>TAVR resulted in better survival and functional status in inoperable patients with severe aortic stenosis with durable hemodynamic benefit on long-term follow-up. However, high residual mortality, even in successfully treated TAVR patients, highlights the need for more strategic patient selection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/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=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00530894.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.114.009834","type":"journal-article","created":{"date-parts":[[2014,9,10]],"date-time":"2014-09-10T02:29:52Z","timestamp":1410316192000},"page":"1483-1492","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":162,"title":["Long-Term Outcomes of Inoperable Patients With Aortic Stenosis Randomly Assigned to Transcatheter Aortic Valve Replacement or Standard Therapy"],"prefix":"10.1161","volume":"130","author":[{"given":"Samir R.","family":"Kapadia","sequence":"first","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Murat","family":"Tuzcu","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj R.","family":"Makkar","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikhar","family":"Agarwal","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susheel","family":"Kodali","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Fontana","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Webb","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mack","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod H.","family":"Thourani","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilis C.","family":"Babaliaros","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard C.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Szeto","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto D.","family":"Pichard","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew R.","family":"Williams","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William N.","family":"Anderson","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi J.","family":"Akin","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Craig","family":"Miller","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin B.","family":"Leon","sequence":"additional","affiliation":[{"name":"From the Cleveland Clinic Foundation, Cleveland, OH (S.R.K., E.M.T., L.G.S., S.A.); Cedars Sinai Medical Center, Los Angeles, CA (R.R.M.); Columbia University Medical Center\/New York Presbyterian Hospital, New York, NY (S.K., M.R.W., C.R.S., M.B.L.); Lenox Hill Hospital, New York, NY (G.P.F.); St. Paul\u2019s Hospital, Vancouver, BC, Canada (J.G.W.); Baylor Healthcare System, Plano, TX (M.M.); Emory University School of Medicine, Atlanta, GA (V.H.T., V.C.B.); Hospital of the University of Pennsylvania,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2012.02.006"},{"key":"e_1_3_4_3_2","first-page":"297","article-title":"Aortic valve stenosis and regurgitation: an overview of management.","volume":"49","author":"Svensson LG","year":"2008","unstructured":"Svensson LG. Aortic valve stenosis and regurgitation: an overview of management. J Cardiovasc Surg (Torino). 2008;49:297\u2013303.","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi471"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200384"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202277"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.014"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.050"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.946533"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.001545"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.06.011"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.112.974899"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2011.164"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.12.033"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.01.055"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.003"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-012-0842-3"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.11.056"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2011.04.005"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.114.009834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:48:19Z","timestamp":1715582899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.114.009834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,21]]},"references-count":20,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2014,10,21]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.114.009834"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.114.009834","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,21]]},"assertion":[{"value":"2014-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-08-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}