Why the study?
While short-term efficacy and safety of TAVR are proven, long-term outcomes compared to SAVR for severe aortic stenosis remain unclear.
Does transcatheter aortic valve replacement improve long-term outcomes (death or disabling stroke) compared to surgical aortic valve replacement in patients with severe aortic stenosis?
Population
7785 patients with severe aortic stenosis across seven trials
Comparison
TAVR vs SAVR
Design
Meta-analysis of randomized controlled trials
Follow-up
Weighted mean 5.76 ± 0.073 years
Key result
Transcatheter aortic valve replacement showed no significant difference in long-term death or disabling stroke compared to surgical aortic valve replacement (HR 1.02; 95% CI 0.93-1.11; P=.70).
Authors
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Supports individualized TAVR or SAVR selection in severe aortic stenosis; reinforces long-term equivalence from randomized evidence.
Meta-Analysis (n=7,785)
Does transcatheter aortic valve replacement improve long-term outcomes (death or disabling stroke) compared to surgical aortic valve replacement in patients with severe aortic stenosis?
Effect estimate: HR 1.02 (95% CI 0.93-1.11)
p-value: p=.70
At nearly 6 years of follow-up, TAVR and SAVR demonstrate similar rates of death or disabling stroke for severe aortic stenosis, though TAVR is associated with higher rates of pacemaker implantation and paravalvular leaks.
Talanas et al. (2024) conducted a meta-analysis in severe aortic stenosis (n=7,785). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on death or disabling stroke (HR 1.02, 95% CI 0.93-1.11, p=.70). Transcatheter aortic valve replacement showed no significant difference in long-term death or disabling stroke compared to surgical aortic valve replacement (HR 1.02; 95% CI 0.93-1.11; P=.70).
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