Seven-Year Valve Durability With Transcatheter or Surgical Aortic Valve Replacement

Article Impact Level: HIGH
Data Quality: STRONG
Summary of  JAMA Cardiology. https://doi.org/10.1001/jamacardio.2026.2299  
Dr. AUTHOR  et al.

Points

This seven-year randomized clinical trial compared the long-term bioprosthetic valve durability of transcatheter aortic valve replacement against traditional open-heart surgery in one thousand low-risk patients.
Structural valve deterioration rates tracked similarly between the two comparison groups over seven years resulting in seven point three percent for transcatheter and seven point six percent for surgery.
All-cause bioprosthetic valve failure affected six point nine percent of transcatheter patients and seven point five percent of surgical patients by the end of the follow-up period.
Subsequent repeat valve procedures were required for six percent of the transcatheter replacement group and five point five percent of the open-heart surgery replacement cohort.
Blood clot complications occurred significantly more often after transcatheter procedures with valve thrombosis impacting five point two percent of transcatheter patients compared to zero point nine percent of surgical patients.

Summary

This analysis evaluated seven-year bioprosthetic valve durability in low-risk patients with severe aortic stenosis. Across the globe, more than 28 million people live with heart valve disease, and approximately 106,000 heart valve replacement procedures are performed annually in the United States alone. As transcatheter aortic valve replacement (TAVR) is increasingly considered for younger, lower-risk cohorts, this investigation sought to compare its long-term durability and functionality against traditional open-heart surgery.

Investigators conducted a randomized trial involving 1,000 low-risk patients assigned to either TAVR or traditional open-heart surgical aortic valve replacement. Regular echocardiograms were evaluated at 30 days, one year, annually through year five, and at year seven. The data revealed that structural valve deterioration occurred at closely matching rates of 7.3% for the TAVR cohort and 7.6% for the surgical cohort.

All-cause bioprosthetic valve failure affected 6.9% of TAVR patients and 7.5% of surgical patients, while a second valve procedure was required in 6% and 5.5% of patients, respectively. Approximately 75% of patients in both groups survived with a fully functioning replacement valve at seven years. However, a notable difference was observed in blood clot formation, with thrombosis occurring more frequently after TAVR at 5.2% compared to 0.9% in the traditional surgery group.

Link to the article: https://jamanetwork.com/journals/jamacardiology/fullarticle/2850866#google_vignette

References

Ternacle, J., Hahn, R. T., Silva, I., Alperi, A., Giuliani, C., Zanuttini, A., Théron, A., Dahou, A., Cristell, N., Woods, T., Guzzetti, E., Turgeon, P. Y., Bernier, M., Mahjoub, H., Paquin, A., Skaf, S., Beaudoin, J., Kodali, S. K., Russo, M., … Burlingame, M. (2026). Seven-year valve durability with transcatheter or surgical aortic valve replacement: An ad hoc analysis of the partner 3 randomized clinical trial. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2026.2299