Design: Secondary analysis of a randomised trial (PARTNER 3), 7-year follow-up
Population: 943 low-surgical-risk patients with severe aortic stenosis
Primary outcome: KCCQ overall summary score over time
Effect: +16.2 points at 1 month (14.3–18.1); +1.9 at 2 years (0.2–3.7); no difference years 3–7

A JACC analysis of PARTNER 3 followed 943 low-surgical-risk patients with severe aortic stenosis (mean age 73.5, predicted surgical mortality 1.9%) randomised to balloon-expandable TAVR or surgical valve replacement, with health status measured through seven years.

Both groups improved substantially and stayed improved. TAVR led on the Kansas City Cardiomyopathy Questionnaire overall score by 16.2 points at one month and 1.9 points at two years, with no difference from years three to seven. At seven years about 60% of each group had an excellent outcome: alive, with a good score and no major decline.

The early advantage of TAVR is real and large, but it is an advantage in recovery, not in how patients feel in the long run. That puts the low-risk decision back where it belongs: on valve durability, future reintervention, coronary access and the patient's own priorities.

Use these data in shared decision-making. A patient who values a quick return to normal life gains from TAVR; a younger patient worried about durability is not trading away long-term quality of life by choosing surgery.

Tell low-risk patients that recovery is faster after TAVR but that quality of life is similar from year three
Weigh valve durability, likely reintervention and coronary access, especially in younger patients
Ask what the patient values most: speed of recovery or long-term durability
Involve the heart team in every low-risk aortic stenosis decision

Why it matters

It removes long-term quality of life as a reason to favour TAVR in younger, low-risk patients.

The statistics, in plain English

A 16-point KCCQ difference is large — about 5 points is usually considered clinically meaningful. The 1.9-point difference at two years is statistically significant but below that threshold, so it is unlikely to be noticed by patients.