Lauck SB, Baron SJ, Irish W, et al. - With a rapid evolution of the treatment of aortic stenosis, differences in the pace of change in the care of patients undergoing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) have been observed. Until 2016, the rate of improvement in TAVR outpaced SAVR. The recent identification of the presence of U‐shaped phenomena indicates a narrowing gap between outcomes.

• Using data from the Medicare Data Set Analytic File 100% Fee for Service database, data of a total of 245,269 patients with SAVR and 188,580 patients with TAVR were retrieved for inclusion; mean±SD ages were 74.3±6.0 years and 80.7±6.9 years, respectively, and there were 36.5% and 46.2% female patients, respectively.

• Higher Elixhauser Comorbidity Index (ECI) scores (6.4±3.6 versus 4.4±3) and frailty (55.4% vs 33.5%) were recorded among patients with TAVR.

• Between 2012 and 2019, there was an increase in TAVR volumes by 61%; in 2017, TAVR volumes surpassed SAVR.

• Until 2016, the main cohort showed an increase in the magnitude of mortality benefit associated with TAVR; although, mortality rates were continuously lower from 2017 to 2019 among those who were undergoing TAVR, attenuation in the magnitude of benefit over SAVR was observed.

• There appeared a similar pattern with readmission.

• Year over year, increasingly shorter lengths of stay were observed in correlation with TAVR vs SAVR.