TAVR was associated with a lower risk of all-cause mortality within the first year compared with SAVR (30-day HR 0.45; 95% CI 0.26-0.77), but the risk was similar in >1-year follow-ups.
Meta-Analysis (n=4,682)
Does TAVR reduce all-cause mortality compared to SAVR in patients with severe aortic stenosis and low surgical risk?
TAVR provides an early survival benefit over SAVR up to 1 year in low-surgical risk patients with severe aortic stenosis, but this benefit attenuates beyond 1 year.
Effect estimate: HR 0.45 (95% CI 0.26-0.77)
Background Limited data exist on long‐term outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). This meta‐analysis aims to elucidate outcome trends following TAVR versus SAVR in patients with severe aortic stenosis and low‐surgical risk. Methods and Results A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases from inception until May 2024, to identify studies comparing TAVR versus SAVR in patients with low‐surgical risk (Society of Thoracic Surgeons predicted risk of mortality score 1‐year follow‐ups. TAVR was associated with a significantly lower risk of cardiovascular mortality, disabling stroke, rehospitalization, new‐onset atrial fibrillation, and a higher risk of permanent pacemaker implantation compared with SAVR during the 30‐day follow‐up. Conclusions TAVR was associated with a lower risk of all‐cause mortality within the first year of post‐procedural follow‐up compared with SAVR. However, the risk of all‐cause mortality was similar in >1‐year follow‐ups.
Kazemian et al. (Fri,) conducted a meta-analysis in severe aortic stenosis and low-surgical risk (n=4,682). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on all-cause mortality (HR 0.45, 95% CI 0.26-0.77). TAVR was associated with a lower risk of all-cause mortality within the first year compared with SAVR (30-day HR 0.45; 95% CI 0.26-0.77), but the risk was similar in >1-year follow-ups.