PARTNER 3 Seven-Year Data Show Equivalent Valve Durability for TAVR and SAVR in Low-Risk Patients

The PARTNER 3 randomized trial assigned low-risk patients to TAVR or SAVR and tracked them with serial echocardiography through year 7. Primary endpoints included stage 2-3 bioprosthetic valve dysfunction and clinical valve failure. Both arms recorded similarly low cumulative incidence of deterioration, wear, and repeat procedures, confirming durable hemodynamic performance out to seven years despite the shift toward younger recipients.

One clear divergence emerged in subclinical leaflet thrombosis, detected in 5.2% of TAVR patients versus 0.9% after surgery. Although absolute event rates remained modest and most cases were subclinical, the fivefold difference raises questions about anticoagulation protocols and long-term monitoring intensity that short-term trials could not address.

These findings extend earlier PARTNER 3 reports and align with five-year data from the Evolut Low Risk trial, yet they also highlight gaps in real-world registries where patient selection and valve types vary. Regulators and guideline committees now have rare randomized durability benchmarks that could support broader TAVR use in patients under 75.

Next steps include 10-year imaging follow-up and linkage to administrative databases to capture rare late failures and stroke signals that may alter class I recommendations.