Why the study?
Limited data exist on long-term outcomes after TAVR and SAVR in patients with severe aortic stenosis and low surgical risk.
Does TAVR reduce all-cause mortality compared to SAVR in patients with severe aortic stenosis and low surgical risk?
Population
4682 patients with severe aortic stenosis and low-surgical risk across 6 randomized trials
Comparison
TAVR vs SAVR
Design
Systematic review and meta-analysis of randomized trials
Key result
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.
Authors
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Early mortality benefit supports TAVR consideration in low-risk severe AS; extends RCT meta-analyses by confirming attenuation beyond 1 year.
Meta-Analysis (n=4,682)
Does TAVR reduce all-cause mortality compared to SAVR in patients with severe aortic stenosis and low surgical risk?
Effect estimate: HR 0.45 (95% CI 0.26-0.77)
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.
Kazemian et al. (2024) 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.