LAUSR

In this issue, Ali et al. studied a cohort of patients who underwent transcatheter aortic valve replacement (TAVR) in United Kingdom from 2007 to 2011. They report on the long‐term results of this cohort. While TAVR is an approved and safe treatment option for inoperable, high, intermediate, and low surgical risk patients, the long‐term durability remains a significant concern. Due to scarcity of sufficient data on long‐term TAVR durability the current US guidelines recommend surgical aortic valve replacement (SAVR) over TAVR for patients who are younger than 65 years of age or with life expectancy of greater than 20 years. TAVR performance is always held to the “gold standard” of surgical valves. There is a growing body of evidence comparing TAVR versus SAVR outcomes. In the Notion trial, at 8‐year follow‐ up, TAVR patients had lower gradients and larger orifice area as compared to SAVR. The rate of structural valve deterioration (SVD) was lower in patients undergoing self‐expanding (SEV) TAVR than SAVR (13.9% vs. 28.3%). In the PARTNER II trial, the gradient and valve area remained unchanged for TAVR, and no patient in the TAVR or SAVR groups had SVD requiring reintervention at 5‐year follow‐up. A recent pooled analysis of 4762 patients showed lower incidence of SVD with self‐expanding, supra‐annular transcatheter valves as compared to SAVR (4.38% vs. 2.20%) at 5 years. This lower risk of SVD was even more distinct in patients with aortic annulus of