PARTNER B: where will it take us?

PARTNER trial, cohort B has taken our cardiovascular community to new heights in multidisciplinary collaboration while raising awareness in the primary care community regarding the shortcomings of noninterventional treatment of symptomatic AS. With a rate of death from any cause at 1 year that is 20% lower with transcatheter aortic valve replacement (TAVR) in comparison with standard medical therapy, TAVR should be considered the new standard of care for patients with AS who are not suitable candidates for surgery. Despite TAVR's initial success, this landmark trial leaves questions about durability, paravalvular regurgitation, and procedural complications unanswered. Nonetheless, TAVR is clearly and unequivocally a new and successful treatment for symptomatic AS. Complication rates in this early stage of experience with a first-generation device are much lower than many had expected, and will not prevent TAVR from moving steadily down the risk spectrum.