PARTNER 2
Placement of Aortic Transcatheter Valves 2
Clinical Question
Population
Patients with severe symptomatic aortic stenosis and an STS-PROM score of 4-8%, indicating intermediate surgical risk, at 57 centers.
TAVR with the SAPIEN XT or SAPIEN 3 balloon-expandable valve
Surgical aortic valve replacement (SAVR)
Primary Endpoint
Composite of death from any cause or disabling stroke at 2 years
Key Findings
The primary endpoint occurred in 19.3% of TAVR patients vs 21.1% of surgery patients at 2 years (p=0.25 for superiority; met noninferiority).
In the transfemoral-access cohort, TAVR was associated with lower rates of death or disabling stroke compared with surgery (16.8% vs 20.4%).
TAVR resulted in significantly lower rates of acute kidney injury (1.3% vs 3.1%), severe bleeding (10.4% vs 43.4%), and new-onset atrial fibrillation (9.1% vs 26.4%).
SAVR was associated with lower rates of major vascular complications (5.5% vs 7.9%) and paravalvular aortic regurgitation.
Hospital length of stay was significantly shorter with TAVR (6 vs 9 days).
Impact on Clinical Practice
Guideline Impact
Limitations
The SAPIEN XT valve used in much of the trial has been superseded by the SAPIEN 3, which has lower paravalvular regurgitation rates.
Two-year follow-up may be insufficient to assess valve durability in a relatively younger intermediate-risk population.
The superiority endpoint was not met in the overall cohort, and the transfemoral subgroup benefit was a prespecified secondary analysis.
How Does This Trial Apply to Your Case?
Clinical trials inform guidelines, but every patient is unique. Our Heart Team evaluates how landmark evidence applies to your specific anatomy, risk profile, and preferences.
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