Revisiting the PARTNER 3 trial: are 5-year hemodynamic findings enough to settle the debate in low-risk aortic stenosis?

This review revisits the 5-year echocardiographic findings from the PARTNER 3 trial, which assessed valve performance in low-surgical-risk patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). While TAVR demonstrated early hemodynamic advantages, including more favourable right ventricular-pulmonary artery coupling and lower valvulo-arterial impedance, these benefits did not consistently translate into superior long-term outcomes. Emerging data from companion publications highlight a potential late mortality in the TAVR group, despite comparable early results. In younger, low-risk patients, long-term survival, not just early hemodynamic metrics, should remain the primary consideration when guiding treatment decisions.