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[Comment] All over for valve surgery for intermediate-risk patients?

Based on the findings of three randomised trials1–3 transcatheter aortic valve replacement (TAVR) is now first-line therapy in patients with severe aortic stenosis who are at high risk or are unsuitable for surgery.4,5 As a consequence of rapid refinements of devices and procedure techniques there is a trend to extend TAVR to lower-risk patients. This trend has been encouraged by small propensity-matched studies and a small randomised trial in intermediate-risk and lower-risk patients, which showed favourable results compared with surgery.