Muneretto C, Solinas M, Folliguet T, et al. - Researchers conducted a multi-institutional study investigating the long-term outcome and an intermediate risk profile of elderly patients with severe aortic stenosis undergoing sutureless vs transcatheter aortic valve implantation. In this study, they included 967 elderly patients (> 75 years) with intermediate risk (Society of Thoracic Surgeons score 4%-8%) and isolated aortic stenosis (sutureless valve = 481; transcatheter aortic valve implantation = 486). Two matched groups of 291 patients were obtained following propensity score matching. The sutureless valve group had significantly lower 30-day mortality and rate of permanent pacemaker implantation. At 5 years, they observed stroke/transient ischemic attack cumulative incidence of 1.4% in the sutureless valve group and 5.3% in the transcatheter aortic valve implantation group. The incidences of perivalvular leak grade II or greater were 1.3% and 9.8% in the sutureless valve group and transcatheter aortic valve implantation group, respectively. Transcatheter aortic valve implantation was identified to be an independent predictor for 5-year mortality and major adverse cardiovascular events. Per these findings, managing aortic stenosis using sutureless valves may result in improved outcomes in elderly patients with an intermediate risk profile when compared with transcatheter aortic valve implantation.