Pooled Periprocedural and Short-Term Outcomes After Transcatheter Aortic Valve Replacement With Contemporary Self-Expanding Valves: A Systematic Review and Meta-Analysis

Background Contemporary self-expanding transcatheter heart valves (SEV) have incorporated design refinements to reduce paravalvular leak (PVL) and pacemaker implantation (PPI). We aimed to characterize clinical outcomes after transcatheter aortic valve replacement (TAVR) with contemporary SEVs in patients with severe aortic stenosis. Methods PubMed, EMBASE, and Scopus were searched through October 5, 2025, for studies reporting procedural, hemodynamic, and clinical outcomes for patients undergoing TAVR with the (1) Navitor or (2) Evolut PRO/ PRO+/ FX. Random-effects meta-analyses pooled single-arm event rates, stratified by SEV group, using the Freeman–Tukey double arcsine transformation. Between-platform differences were assessed using subgroup interaction testing. Results Fifty-two studies (n = 21,349; weighted mean age 82 years; mean Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) 4.8%) were included. At 30 days, all-cause mortality was low among Evolut and Navitor cohorts (1.4% and 1.5%; p=0.63), and device success was high for both platforms (92.1% and 93.0%; p=0.73). Moderate or greater PVL occurred in 2.5% and 1.1% of Evolut and Navitor cohorts, respectively (p = 0.12), mild PVL occurred in 31.1% and 19.9% (p = 0.046), and new PPI occurred in 13.4% and 15.3%, respectively. Mean gradients remained low among Evolut and Navitor cohorts at 1 year (7.7 and 7.3 mmHg; p=0.65), while effective orifice area was higher among Evolut cohorts at 1 year (2.1 and 1.8 cm 2 ; p < 0.001) (p = p-interaction). Conclusions Navitor and Evolut PRO/PRO+/FX both demonstrated high device success, low mortality, favorable hemodynamic performance, and low rates of moderate or greater PVL at 1-year follow-up. Mild PVL and new PPI remained frequent. Observed comparative signals should be interpreted as indirect hypothesis-generating findings.