Analysis of the longest follow-up data yet suggests major outcomes are similar after trans-catheter (TAVR) or surgical aortic valve replacement (SAVR) in low-risk patients.

But secondary outcomes differ, with atrial fibrillation more common in surgical patients, while rates of post-procedural pacemaker implantation and paravalvular leaks are higher with TAVR.

The NOTION (Nordic Aortic Valve Intervention) trial randomised 145 Danish and Swedish patients with isolated severe aortic valve stenosis to TAVR and 135 to SAVR in 2009-2013. Patients were aged over 70 years, with a mean age of 79, and were at low surgical risk.

The five-year results confirmed the main outcomes already reported for 30 days and one-year follow-up: there was no difference in all-cause mortality, stroke or MI between the two approaches.