Key result
TAVR improves 2-year survival over SAVR in women, particularly those at high surgical risk.
Why the study?
Women have shown better survival than men after TAVR, but scant data exist on the sex-based survival benefit of TAVR over SAVR as a function of surgical risk and time.
Does TAVR improve survival compared to SAVR in women and men with varying surgical risk profiles?
Systematic Review (n=13,800)
Does TAVR improve survival compared to SAVR in women and men with varying surgical risk profiles?
TAVR provides a selective long-term survival advantage over SAVR in women, particularly those at high surgical risk.
OBJECTIVES: The aim of this study was to explore the time course of survival advantage of TAVR over SAVR as function of the patients' risk and sex. BACKGROUND: Women have been reported to have better survival than men undergoing transcatheter aortic valve replacement (TAVR). However, scant data on the sex-based survival benefit of TAVR over surgical aortic valve replacement (SAVR) are available. METHODS: A systematic review of studies reporting clinical outcomes of men and women undergoing TAVR or SAVR was performed. Studies were divided into two groups according to average patient's risk score and the interplay of surgical risk and sex on outcomes were analyzed. RESULTS: Eight studies involving 6,596 women and 7,204 men patients were extracted. Unlike mens, women patients had survival advantage from TAVR over SAVR that became substantial at 1 year from index procedure and persisted at 2-year of follow-up. Moreover, this sex-based TAVR survival advantage was mainly observed in higher surgical risk patients. Men showed a significantly lower rate of residual paravalvular leak after SAVR. CONCLUSIONS: Women patients had a selective mortality benefit from TAVR compared to SAVR. This sex-based TAVR benefit was mainly observed in high surgical risk patients beyond 1 year from procedure.
No takes yet. Share an insight, caveat, or question.
Ueshima et al. (2019) conducted a systematic review in Aortic valve replacement (n=13,800). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Survival. Transcatheter aortic valve replacement provided a selective survival advantage over surgical replacement in women, particularly those at high surgical risk, persisting at 2 years of follow-up.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: