This study, conducted by the Evolut Low Risk Trial Investigators, aimed to evaluate the safety and effectiveness of transcatheter aortic-valve replacement (TAVR) with a self-expanding supraannular bioprosthesis in low-risk patients with severe aortic stenosis. The trial was a randomized, noninferiority study comparing TAVR to surgical aortic-valve replacement (SAVR) in 1468 patients. The primary endpoint was a composite of death or disabling stroke at 24 months, analyzed using Bayesian methods. Key findings include: - The 24-month incidence of the primary endpoint was 5.3% in the TAVR group and 6.7% in the SAVR group, with a noninferiority margin of 1.4 percentage points. - TAVR was associated with a lower incidence of disabling stroke, acute kidney injury, bleeding events, and atrial fibrillation compared to SAVR. - TAVR resulted in better functional improvement at 30 days, as indicated by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score. - Aortic-valve hemodynamics improved in both groups, with lower mean gradients and larger effective orifice areas in the TAVR group. - The study concluded that TAVR with a self-expanding supraannular bioprosthesis was noninferior to SAVR in terms of the risk of death or disabling stroke at 24 months in low-risk patients. The study highlights the potential benefits of TAVR as an alternative to SAVR in low-risk patients, offering a safer and more effective option for aortic valve replacement.This study, conducted by the Evolut Low Risk Trial Investigators, aimed to evaluate the safety and effectiveness of transcatheter aortic-valve replacement (TAVR) with a self-expanding supraannular bioprosthesis in low-risk patients with severe aortic stenosis. The trial was a randomized, noninferiority study comparing TAVR to surgical aortic-valve replacement (SAVR) in 1468 patients. The primary endpoint was a composite of death or disabling stroke at 24 months, analyzed using Bayesian methods. Key findings include: - The 24-month incidence of the primary endpoint was 5.3% in the TAVR group and 6.7% in the SAVR group, with a noninferiority margin of 1.4 percentage points. - TAVR was associated with a lower incidence of disabling stroke, acute kidney injury, bleeding events, and atrial fibrillation compared to SAVR. - TAVR resulted in better functional improvement at 30 days, as indicated by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score. - Aortic-valve hemodynamics improved in both groups, with lower mean gradients and larger effective orifice areas in the TAVR group. - The study concluded that TAVR with a self-expanding supraannular bioprosthesis was noninferior to SAVR in terms of the risk of death or disabling stroke at 24 months in low-risk patients. The study highlights the potential benefits of TAVR as an alternative to SAVR in low-risk patients, offering a safer and more effective option for aortic valve replacement.