Why the study?
TAVR was recently approved by the FDA for lower risk patients with severe aortic stenosis, warranting a meta-analysis comparing 30-day and 1-year outcomes between TAVR and SAVR in this population.
Does transcatheter aortic valve replacement reduce 30-day and 1-year all-cause mortality compared to surgical aortic valve replacement in lower risk patients?
Population
4,859 lower risk patients with Society of Thoracic Surgeons score < 4% or equivalent
Comparison
TAVR vs SAVR
Follow-up
1 year
Key result
Transcatheter aortic valve replacement significantly reduced the risk of 30-day all-cause mortality by 40.1% compared to surgical aortic valve replacement in lower risk patients.
Authors
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Supports TAVR preference in lower-risk aortic stenosis; extends randomized evidence beyond high- and intermediate-risk populations.
Meta-Analysis (n=4,859)
Yes
Does transcatheter aortic valve replacement reduce 30-day and 1-year all-cause mortality compared to surgical aortic valve replacement in lower risk patients?
Effect estimate: RR 0.59 (95% CI 0.38 - 0.92)
p-value: p=0.02
In lower risk patients with severe aortic stenosis, TAVR significantly reduces 30-day all-cause mortality compared to SAVR, though it is associated with higher rates of permanent pacemaker implantation and vascular complications.
Khan et al. (2020) conducted a meta-analysis in severe aortic stenosis (n=4,859). Transcatheter Aortic Valve Replacement (TAVR) vs. Surgical Aortic Valve Replacement (SAVR) was evaluated on 30-day all-cause mortality (RR 0.59, 95% CI 0.38 - 0.92, p=0.02). Transcatheter aortic valve replacement significantly reduced the risk of 30-day all-cause mortality by 40.1% compared to surgical aortic valve replacement in lower risk patients.
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