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Transcatheter aortic valve replacement (TAVR) generally has been reserved for patients with severe aortic stenosis who are at intermediate-to-high risk for major complications from surgical aortic valve replacement. Now, in two randomized trials, researchers have compared TAVR and surgery in symptomatic patients whose surgical risks are low. In both trials, stroke was included as an endpoint, given that periprocedural stroke rates were relatively high in early TAVR trials.
In one trial, 1000 low-risk patients were randomized to receive TAVR (with a balloon-expandable prosthesis) or valve-replacement surgery. At 1 year, the incidence of the combined primary endpoint (i.e., death, stroke, or rehospitalization) was significantly lower with TAVR…