{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:02:44Z","timestamp":1792497764180,"version":"4.5.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","funder":[{"name":"Abbott"},{"name":"Boston Scientific"},{"name":"Edwards Lifesciences"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,11,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Transcatheter aortic valve replacement (TAVR) is increasingly performed in younger, low surgical risk patients. The NOTION-2 study (The Nordic Aortic Valve Intervention) reports midterm outcomes in low-risk patients age 60 to 75 years with severe tricuspid or bicuspid aortic stenosis undergoing TAVR or surgical valve replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A total of 370 patients (mean age, 71.1 years; mean Society of Thoracic Surgeons Predicted Risk of Mortality, 1.2%) were enrolled and randomized 1:1 to TAVR or surgery. This follow-up study reports clinical and echocardiographic outcomes up to 3 years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>At 3 years, the primary composite end point (death, stroke, or procedure-, valve-, or heart failure\u2013related hospitalization) occurred in 16.1% of patients with TAVR versus 12.6% in surgical patients (hazard ratio, 1.3; 95% CI, 0.8\u20132.2%; I=0.4). Among patients with tricuspid aortic stenosis, rates were similar (14.5% versus 14.4%), whereas patients with bicuspid aortic stenosis had a statistically nonsignificant higher risk with TAVR (20.4% versus 7.8%; hazard ratio, 2.9; 95% CI, 0.9\u20139.0). The risk of moderate or greater structural valve deterioration at 3 years was 4.5% and 5.2% for transcatheter and surgical aortic bioprostheses, respectively (hazard ratio, 1.2; 95% CI, 0.4\u20133.1). Bioprosthetic valve failure rates were also comparable: 1.6% in the TAVR group and 2.9% in the surgical group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>For patients age 60 to 75 years with severe aortic stenosis who are at low surgical risk, 3-year clinical outcomes are similar between TAVR and surgery. Both procedures are associated with low rates of structural valve deterioration and need for reintervention.<\/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:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02825134.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.076678","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T15:45:42Z","timestamp":1756568742000},"page":"1326-1337","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Three-Year Follow-Up of the NOTION-2 Trial: TAVR Versus SAVR to Treat Younger Low-Risk Patients With Tricuspid or Bicuspid Aortic Stenosis"],"prefix":"10.1161","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-7127","authenticated-orcid":true,"given":"Troels H\u00f8jsgaard","family":"J\u00f8rgensen","sequence":"first","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-3795","authenticated-orcid":true,"given":"Mikko","family":"Savontaus","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9229-4777","authenticated-orcid":true,"given":"Yannick","family":"Willemen","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7842-8707","authenticated-orcid":true,"given":"\u00d8yvind","family":"Bleie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Haukeland University Hospital, Bergen, Norway (\u00d8.B., R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3474-2438","authenticated-orcid":true,"given":"Oskar","family":"Anger\u00e5s","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6671-5023","authenticated-orcid":true,"given":"Matti","family":"Niemela","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical Research Center, Oulu University Hospital, Finland (M.N., J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5475-5044","authenticated-orcid":true,"given":"Ingibj\u00f6rg J.","family":"Gudmundsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Landspitali, Reykjav\u00edk, Iceland (I.J.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Khokhar","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-0263","authenticated-orcid":true,"given":"Ulrik","family":"Sartipy","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (U.S.), Karolinska University Hospital, Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0363-7472","authenticated-orcid":true,"given":"Hanna","family":"Dagneg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Cardiology (T.H.J., Y.W., A.K., O.D.B.), Rigshospitalet, Copenhagen University Hospital, Denmark."},{"name":"Department of Cardiothoracic Surgery, Odense University Hospital, Denmark (H.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6906-8877","authenticated-orcid":true,"given":"Mika","family":"Laine","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Helsinki 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The United Kingdom Transcatheter Aortic Valve Implantation (UK TAVI) trial: five-year outcomes. Presented at: EuroPCR 2025. May 21 2025. 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