Why the study?
TAVR is increasingly used in patients with AS at low risk for SAVR, despite uncertainty regarding medium- and long-term clinical outcomes.
Does transcatheter aortic valve replacement reduce mortality, rehospitalization, or stroke in low-risk patients with aortic valve stenosis compared to surgical aortic valve replacement?
Population
4487 low-risk patients with bicuspid or tricuspid AS across six RCTs
Comparison
TAVR vs SAVR
Design
Updated meta-analysis of randomized controlled trials
Follow-up
Up to 5 years
Key result
TAVR in low-risk patients with aortic stenosis significantly reduced 1-year all-cause mortality compared with SAVR (RR 0.60; 95% CI 0.41-0.98; p=0.01), but no difference was seen at 5 years.
Authors
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Supports TAVR for 1-year mortality reduction in low-risk aortic stenosis; confirms early benefit but leaves long-term equivalence open.
Meta-Analysis (n=4,487)
Does transcatheter aortic valve replacement reduce mortality, rehospitalization, or stroke in low-risk patients with aortic valve stenosis compared to surgical aortic valve replacement?
Effect estimate: RR 0.60 (95% CI 0.41-0.98)
p-value: p=0.01
In low-risk patients with aortic stenosis, TAVR reduces 1-year all-cause mortality and rehospitalization compared to SAVR, though this survival benefit is attenuated by 5 years.
Meeus et al. (2025) conducted a meta-analysis in aortic valve stenosis (AS) at low risk for surgical aortic valve replacement (n=4,487). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on 1-year all-cause mortality (RR 0.60, 95% CI 0.41-0.98, p=0.01). TAVR in low-risk patients with aortic stenosis significantly reduced 1-year all-cause mortality compared with SAVR (RR 0.60; 95% CI 0.41-0.98; p=0.01), but no difference was seen at 5 years.