Key result
Compared with SAVR, TAVR was not associated with a significantly lower rate of long-term stroke mortality (p=0.57).
Why the study?
Does TAVR reduce long-term mortality due to stroke and cardiogenic causes compared to SAVR in patients with severe symptomatic aortic stenosis?
Meta-Analysis (n=14,601)
Does TAVR reduce long-term mortality due to stroke and cardiogenic causes compared to SAVR in patients with severe symptomatic aortic stenosis?
p-value: p=0.57
Over a long-term follow-up of 5 to 10 years, SAVR was more effective than TAVR in reducing cardiogenic mortality, while neither procedure significantly decreased long-term stroke mortality.
TAVR confers no long-term stroke mortality advantage over SAVR; challenges assumptions of superiority and leaves optimal valve selection open.
Background and objectives: One of the leading causes of mortality and morbidity in people over the age of 50 is stroke. The acceptance of transcatheter aortic valve replacement (TAVR) as a treatment option for severe symptomatic aortic stenosis (AS) has increased as a result of numerous randomized clinical trials comparing surgical aortic valve replacement (SAVR) and TAVR in high- and intermediate-risk patients, showing comparable clinical outcomes and valve hemodynamics. Materials and Methods: An electronic search of Medline, Google Scholar and Cochrane Central was carried out from their inception to 28 September 2022 without any language restrictions. Results: Our meta-analysis demonstrated that, as compared with SAVR, TAVR was not linked with a lower stroke ratio or stroke mortality. It is clear from this that the SAVR intervention techniques applied in the six studies were successful in reducing cardiogenic consequences over time. Conclusions: A significantly decreased rate of mortality from cardiogenic causes was associated with SAVR. Additionally, when TAVR and SAVR were compared for stroke mortality, the results were nonsignificant with a p value of 0.57, indicating that none of these procedures could decrease stroke-related mortality.
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Ion et al. (2022) conducted a meta-analysis in Severe symptomatic aortic stenosis (n=14,601). Transcatheter Aortic Valve Replacement (TAVR) vs. Surgical Aortic Valve Replacement (SAVR) was evaluated on Stroke mortality (95% CI -62.81 to 34.33, p=0.57). Compared with SAVR, TAVR was not associated with a significantly lower rate of long-term stroke mortality (p=0.57).
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