What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Aortic valve disease requiring TAVR. Intervention: Transfemoral approach and CoreValve vs. Transapical approach and Edwards Valve. Primary outcome: 30-day stroke post-TAVR.

What question did this study set out to answer?

The aim is to compare the risk of stroke associated with different TAVR approaches and valve designs.

June 19, 2026

Influence of Transcatheter Aortic Valve Replacement Strategy and Valve Design on Stroke After Transcatheter Aortic Valve Replacement

Key Result

The risk of 30-day stroke after TAVR was similar between transfemoral and transapical approaches (2.8% vs 2.8% in multicenter studies) and between CoreValve and Edwards Valve designs.

Key Points

The aim is to compare the risk of stroke associated with different TAVR approaches and valve designs.
Conducted systematic review of studies on stroke risk post-TAVR.
Pooled data from 25 multicenter registries and 33 single-center studies.
Followed established meta-analytical guidelines for analysis.
No significant difference in 30-day stroke rates between transfemoral and transapical approaches.
Stroke rates were similar for CoreValve and Edwards Valve types after TAVR.
Overall decline in stroke risk noted with improved technology and experience.

Study Design

Type

Meta-Analysis

Multicenter

Yes

Structured PICO

Does the TAVR approach (transfemoral vs. transapical) or valve design (CoreValve vs. Edwards Valve) affect the risk of 30-day stroke in patients undergoing TAVR?

Population

Patients undergoing transcatheter aortic valve replacement across 25 multicenter registries and 33 single-center studies.

Intervention

Transfemoral (TF) approach or CoreValve design for TAVR

Comparator

Transapical (TA) approach or Edwards Valve design for TAVR

Outcome

30-day stroke post-TAVRhard clinical

The risk of 30-day stroke after TAVR is similar regardless of the approach (transfemoral vs. transapical) or valve type (CoreValve vs. Edwards Valve).

Main Result

Absolute Event Rate: 2.8% vs 2.8%

Abstract

OBJECTIVES: The study undertook a systematic review to establish and compare the risk of stroke between the 2 widely used approaches (transfemoral TF vs. transapical TA) and valve designs (CoreValve, Medtronic, Minneapolis, Minnesota vs. Edwards Valve, Edwards Lifesciences, Irvine, California) for transcatheter aortic valve replacement (TAVR). BACKGROUND: There has been a rapid adoption and expansion in the use of TAVR. The technique is however far from perfect and requires further refinement to alleviate safety concerns that include stroke. METHODS: All studies reporting on the risk of stroke after TAVR were identified using an electronic search and pooled using established meta-analytical guidelines. RESULTS: 25 multicenter registries and 33 single-center studies were included in the analysis. There was no difference in pooled 30-day stroke post-TAVR between the TF and TA approach in multicenter (2.8% 95% confidence interval (CI): 2.4 to 3.4 vs. 2.8% 95% CI: 2.0 to 3.9) and single-center studies (3.8% 95% CI: 3.1 to 4.6 vs. 3.4% 95% CI: 2.5 to 4.5). Similarly, there was no difference in pooled 30-day stroke post TAVR between the CoreValve and Edwards Valve in multicenter (2.4% 95% CI: 1.9 to 3.2 vs. 3.0% 95% CI: 2.4 to 3.7) and single-center studies (3.8% 95% CI: 2.8 to 4.9 vs. 3.2% 95% CI: 2.4 to 4.3). There was a decline in stroke risk with experience and technological advancement. There was no difference in the outcome of 30-day stroke between TAVR and surgical aortic valve replacement. CONCLUSIONS: Our findings suggest that the risk of 30-day stroke after TAVR is similar between the approaches and valve types. There has been a decline in stroke risk after TAVR with improvements in valve technology, patient selection, and operator experience.

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