In the first analysis to validate observed clinical outcomes, two trials compared transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (AVR). Valve dysfunction was found to be less common after five years in TAVR. Long-term performance is a critical consideration in patients who undergo TAVR, especially when they are younger and lower risk. These promising results were driven by lower rates of valve deterioration and prothesis-patient mismatch.