Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial.
MV, M., MJ, M., P, P., RT, H., R, M., VH, T., SK, K., SR, K., P, G., & V, B. (2026). Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial.. JACC. Cardiovascular interventions. https://doi.org/10.1016/j.jcin.2026.05.023
MV M, MJ M, P P, RT H, R M, VH T, et al. Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial.. JACC. Cardiovascular interventions. 2026; doi: 10.1016/j.jcin.2026.05.023
MV M, MJ M, P P, et al. Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial.[J]. JACC. Cardiovascular interventions. 2026. DOI: 10.1016/j.jcin.2026.05.023.
@article{mv2026,
author = {Madhavan MV and Mack MJ and Pibarot P and Hahn RT and Makkar R and Thourani VH and Kodali SK and Kapadia SR and Genereux P and Babaliaros V},
title = {Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial.},
journal = {JACC. Cardiovascular interventions},
year = {2026},
doi = {10.1016/j.jcin.2026.05.023},
note = {PMID: 42508852},
}
TY - JOUR AU - Madhavan MV AU - Mack MJ AU - Pibarot P AU - Hahn RT AU - Makkar R AU - Thourani VH AU - Kodali SK AU - Kapadia SR AU - Genereux P AU - Babaliaros V TI - Impact of Aortic Annulus Size on Outcomes After Aortic Valve Replacement: The PARTNER 3 Trial. T2 - JACC. Cardiovascular interventions PY - 2026 DO - 10.1016/j.jcin.2026.05.023 AN - PMID:42508852 ER -
BACKGROUND: There are limited studies comparing the impact of transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) by annular size. OBJECTIVES: The aim of this post hoc analysis from the PARTNER (Placement of Aortic Transcatheter Valves) 3 trial was to assess the relationship between annular size and outcomes among patients with severe aortic stenosis (AS) who underwent TAVR or SAVR. METHODS: Low-risk patients with severe, symptomatic AS were randomized to TAVR using the balloon-expandable SAPIEN 3 valve or SAVR. Patients were stratified by computed tomographic angiography-derived aortic annular area (small, ≤430 mm2; large, >430 mm2). The primary endpoint was the composite of death, stroke, or rehospitalization. Interactions among annular size, treatment strategy, and adjudicated 5-year clinical outcomes were assessed. RESULTS: Of the 925 patients with available computed tomographic angiography-derived annular size, 293 had small and 632 had large aortic annuli, respectively. Median follow-up duration was 5.2 years (Q1-Q3: 5.0-6.0 years). Five-year rates of the primary endpoint were similar for TAVR and SAVR in the overall cohort, results that were consistent for patients with small (21.2% vs 31.0%; OR: 0.60; 95% CI: 0.35-1.02) and large (23.5% vs 25.5%; OR: 0.90; 95% CI: 0.62-1.29) annuli, without effect modification by annular size (P for interaction = 0.22). Rates of bioprosthetic valve failure were similar and low at 5 years, without effect modification by annular size. Five-year health status was also similar between treatment modalities across annulus strata (P for interaction = 0.12). CONCLUSIONS: TAVR with the SAPIEN 3 valve led to similar 5-year clinical and health status outcomes compared with SAVR, irrespective of annular size. (PARTNER 3 Trial: Safety and Effectiveness of the SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic Stenosis [P3]; NCT02675114).