Witberg G, et al. - This meta-analysis was designed in order to inspect the benefits of transcatheter aortic valve replacement (TAVR) in high-risk aortic stenosis (AS) patients when compared to surgical aortic valve replacement (SAVR). Data shed light on the connection between TAVR with increased mortality risk in patients at low surgical risk. However, SAVR persisted as the treatment of choice for these patients.

Methods

• The design of this research was a systematic review and meta-analysis study.
• Experts examined the randomized controlled trials (RCTs) and observational studies with propensity score matching (PSM) of TAVR vs surgical aortic valve replacement (SAVR) in patients who are at low surgical risk.
• The all-cause mortality served as the primary outcome.
• The secondary outcomes consisted of stroke, myocardial infarction, bleeding, and various procedural complications.

Results

• This research comprised of 6 studies (2 RCTs and 4 PSM studies) encompassing 3,484 patients.
• The range of follow-up was from 3 months to 3 years (median 2 years).
• Findings unveiled similar short-term mortality with TAVR and SAVR (2.2% for TAVR and 2.6% for SAVR, RR 0.89, 95% CI 0.56-1.41, P=0.62).
• Nonetheless, TAVR exhibited an interconnection with increased risk for intermediate-term mortality (17.2% for TAVR and 12.7% for SAVR, RR 1.45, 95% CI 1.11-1.89, P=0.006).
• Data shed light on a link between TAVR with reduced risk for bleeding and renal failure and an increase in vascular complications and Pacemaker implantation, with regard to periprocedural complications.