A major clinical trial presented at a leading cardiology conference found that replacing a narrowed heart valve early — before it becomes severely restricted — cut the chance of dying or being hospitalised with heart failure within two years by around a third.
The findings come from the PROGRESS trial, presented at TCT 2026, one of the world’s largest interventional cardiology meetings. The trial looked at patients with moderate aortic stenosis (a condition where the aortic valve, which controls blood flow out of the heart, becomes stiff and narrow) who also had features that put them at higher risk of complications.
Patients in the trial were split into two groups. Those who received transcatheter aortic-valve replacement — a procedure where a new valve is inserted via a thin tube through a blood vessel, without open-heart surgery — had a 16.7% rate of death or serious heart-failure events within two years. Those who were monitored but did not receive the procedure had a rate of 23.9%. Separately, the trial found that hospitalisation for heart failure alone was approximately halved in the group who received the procedure (7.4% vs 14.9%).
That’s a meaningful gap.
Aortic stenosis affects a significant number of older adults. Until now, the standard approach for moderate disease has generally been watchful waiting — monitoring the valve with regular scans and acting only when it worsens to a severe stage. The PROGRESS trial, according to the *New England Journal of Medicine* where the full results were published, challenges whether that wait-and-see approach is always the right one for higher-risk patients.
The findings are likely to prompt discussion among cardiologists about when to intervene. But they apply to a specific group — patients with moderate stenosis *and* defined high-risk features — so the results don’t automatically change guidance for everyone with the condition.
Anyone concerned about heart valve symptoms — which can include breathlessness, chest tightness, or feeling faint on exertion — should speak to their GP rather than drawing conclusions from trial data alone. NHS 111 is also available around the clock for urgent health questions that can’t wait for a GP appointment.
Source: @NEJM