From NOTIONs to nuances: TAVR and SAVR in low-risk patients

The NOTION trial, in this 10-year follow-up report, comprehensively compares transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients. The study reveals similar outcomes in terms of mortality, stroke, and myocardial infarction. TAVR demonstrates advantages such as improved effective orifice area and transprosthetic gradients, along with reduced rates of new-onset atrial fibrillation. However, it is associated with higher rates of permanent pacemaker implantation and paravalvular leaks. Concerns exist regarding the generalizability of findings and unblinding during outcome assessments.