TAVR and SAVR in Low-Risk Patients Show Comparable Outcomes in 7-Year PARTNER 3 Data

November 10, 2025—The 7-year results from the PARTNER 3 trial demonstrated no significant difference in clinical outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) among patients at low surgical risk with severe, symptomatic aortic stenosis.

The findings were presented at the TCT 2025 scientific symposium held October 25-28 and published simultaneously by Martin B. Leon, MD, et al in The New England Journal of Medicine.

As summarized in the TCT press release, the PARTNER 3 trial randomized 1,000 patients (1:1) at 71 clinical sites to undergo transfemoral TAVR with the balloon-expandable Sapien 3 valve (Edwards Lifesciences) or SAVR.

The as-treated population included 496 patients in the TAVR group and 454 patients in the SAVR group, with approximately all receiving the intended valve. At randomization, the mean age was 73.3 years, 69.3% of patients were male, and the mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 1.9%.

According to TCT, the 7-year findings included the following:

• The first primary endpoint—a composite of death, stroke, or rehospitalization related to the procedure, valve, or heart failure—occurred in 34.6% of TAVR patients versus 37.2% of SAVR patients (hazard ratio, 0.87; 95% CI, 0.70–1.08; P = .21).
• The endpoint components for TAVR versus SAVR included death from any cause (19.5% vs 16.8%; P = .31); stroke (8.5% vs 8.1%; P = .99); and rehospitalization (20.6% vs 23.5%; P = .18). There were no significant differences in cardiovascular or noncardiovascular death between groups.
• The second primary endpoint—a hierarchical composite of death, disabling stroke, nondisabling stroke, and rehospitalization days—yielded a win ratio of 1.04 (95% CI, 0.84–1.30; P = .70).
• Other assessments, including all-cause bioprosthetic valve failure per VARC-3 criteria, aortic valve reintervention, and Kansas City Cardiomyopathy Questionnaire scores, were similar between groups.

Additionally, aortic valve area was comparable between groups, although mean gradients were slightly higher with TAVR at 7 years. Mild or greater paravalvular regurgitation remained more common among TAVR patients throughout follow-up, noted the press release.

“As TAVR is increasingly performed in younger patients with longer life expectancy, understanding long-term transcatheter and surgical valve durability is essential to inform patient-centered decision making,” commented PARTNER 3 investigator Michael J. Mack, MD, in the TCT press release. “Having this extended clinical and echocardiographic follow-up shows that TAVR is a safe and effective option for this low-risk population.”