Evidence map›Paper›PMID 41611313›Full record

ArticleOpen heart2026

Multidisciplinary team-guided management of severe aortic stenosis: 5-year outcomes following TAVI versus conservative treatment.

Jane Manning, Louis J Koizia, Melanie Dani, Iqbal Malik, Matteo Di Giovannantonio, Benjamin H L Harris, Michael B Fertleman

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jane ManningCutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK.
Louis J KoiziaCutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK louis.koizia05@imperial.ac.uk.ORCID http://orcid.org/0000-0003-4074-6926
Melanie DaniCutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK.
Iqbal MalikHammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Matteo Di GiovannantonioDepartment of Oncology, University of Oxford, Oxford, UK.
Benjamin H L HarrisCutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK.
Michael B FertlemanCutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMultidisciplinary team (MDT) meetings are central to treatment decisions in aortic stenosis (AS), particularly for borderline or high-risk patients. This study evaluates long-term, real-world outcomes according to MDT-selected management strategy within routine clinical practice in this clinically important patient group.

methodsWe conducted a retrospective cohort study of all patients with severe AS discussed at a transcatheter aortic valve implantation (TAVI) MDT at a tertiary UK centre between January 2014 and December 2016. Patients were categorised as TAVI or non-TAVI (conservatively managed). Demographic, clinical and frailty data were collected, including Charlson Comorbidity Index, Clinical Frailty Scale (CFS) and number of prescribed medications. Survival was analysed using Kaplan-Meier estimates and Cox proportional hazards modelling adjusted for age, sex, frailty, comorbidity burden and medication count.

resultsA total of 373 patients were included (TAVI=178; non-TAVI=195). Patients undergoing TAVI were younger (81.3 years vs 83.5 years; p=0.01) and less frail (CFS 3.9 vs 4.9; p<0.01). Survival at 1 year, 2 years and 5 years was significantly higher following TAVI (87.6%, 74.7%, 44.9%) compared with conservative management (60.8%, 44.2%, 12.1%; p<0.001). Median survival was 53 months after TAVI versus 20 months without intervention. On multivariable analysis, TAVI was independently associated with reduced mortality (HR 0.38, 95% CI 0.28 to 0.50; p<0.001).

conclusionsIn patients with severe AS discussed at MDT, TAVI was associated with a substantial and durable survival advantage compared with conservative management. These findings highlight the poor prognosis of untreated severe AS and support systematic inclusion of conservatively managed patients in interventional registries to better inform MDT deliberation and shared decision-making.

Indexed as

Aortic ValveAortic Valve StenosisConservative TreatmentPatient Care TeamTranscatheter Aortic Valve ReplacementAgedAged, 80 and overClinical Decision-MakingFemaleHumansMaleRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsAortic Valve StenosisQuality of Health CareTranscatheter Aortic Valve Replacement

Identifiers

PMID41611313
PMCPMC12863368

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.