ObjectiveThe purpose of this meta‐analysis is to compare the safety and efficacy of transcatheter aortic‐valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in low‐surgical‐risk patients.BackgroundTAVR is proven to be safe and effective in patients with high‐ and intermediate‐risk aortic stenosis. However, there is limited data on the safety and efficacy of TAVR in patients with low surgical risk.MethodsWe conducted an electronic database search of all published data for studies that compared TAVR to SAVR in low‐surgical‐risk patients (mean society for thoracic surgery [STS] score <4% and/or logistic EuroScore <10%) and reported on subsequent all‐cause mortality, cardiac mortality, stroke rates, and other outcomes of interest. Event rates were compared with a forest plot of odds ratio using a random‐effects model assuming interstudy heterogeneity.ResultsA total of seven studies (n = 6,293 patients; TAVR = 2,912; and SAVR = 3,381) were included in the final analysis. There was no significant difference between TAVR and SAVR in terms of all‐cause mortality (OR 0.82; 95% CI 0.50–1.36, I2 = 51%), cardiac mortality (OR 0.57; 95% CI 0.32–1.02, I2 = 0%), new pacemaker implantation (OR = 3.11; 95% CI 0.58–16.60, I2 = 89%), moderate/severe paravalvular leak (PVL; OR 3.50; 95% CI 0.64–19.10, I2 = 54%) and rate of stroke (OR 0.63; 95% CI 0.34–1.15, I2 = 39%) at 1‐year follow‐up. TAVR was found to have a significantly lower incidence of atrial fibrillation (AF; OR 0.15, 95% CI 0.10–0.24, I2 = 38%) as compared to SAVR.ConclusionThe results of our meta‐analysis demonstrate similar rates of all‐cause mortality, cardiac mortality, and stroke at 1‐year follow‐up in patients undergoing TAVR and SAVR. TAVR is associated with a lower incidence of AF relative to SAVR. However, there was a significantly higher incidence of PVL with TAVR compared to SAVR.

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Objective: This meta-analysis sought to evaluate the outcomes of absorb bioresorbable vascular scaffolds (BVS) compared with second-generation drug-eluting stents (DES) after 3 years, the approximate time of complete polymer bioresorption.Background: BVS were found to be inferior to second-generation DES in early and mid-term outcomes with a higher rate of target vessel myocardial infarction (TV-MI) and device thrombosis (DT). Improper implantation techniques and incomplete bioresorption of the poly-L-lactide (PLLA) polymer were sighted as possible reasons. Methods:We conducted an electronic database search for all randomized control trials that compared absorb BVS to second-generation DES and reported outcomes of interest after 3 years of absorb BVS implantation. Assuming interstudy heterogeneity, a random-effects analysis was conducted with odds ratio as the effect size of choice to compare the event rates between the two groups. Results: A total of four studies (n = 3,245, BVS = 2075, DES = 1,170) were included in the final analysis. Pooled analysis revealed that there was no difference between absorb BVS and second-generation DES with respect to target lesion failure (TLF) (OR = 1.23, 95% CI = 0.73-2.07, p = 0.44), TV-MI (OR = 1.03, 95% CI = 0.42-2.53, p = 0.95), target lesion revascularization (TLR) (OR = 1.61, 95% CI = 0.77-3.33, p = 0.20) and definite/probable DT (OR = 0.71, 95% CI = 0.10-5.07, p = 0.74). Also, there was no difference in cardiac mortality (OR = 0.66, 95% CI = 0.22-1.94, p = 0.45). Conclusions: Between 3 and 4 years of follow-up, patients receiving absorb BVS did not have significantly different outcomes, in terms of TLF, TV-MI, TLR, DT, and cardiac mortality, compared to DES. K E Y W O R D S absorb, bioresorbable vascular scaffolds, clinical outcomes, drug-eluting stents

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Introduction: The purpose of this meta-analysis is to compare the efficacy of MitraClip plus medical therapy versus medical therapy alone in patients with functional mitral regurgitation (FMR). FMR caused by left ventricular dysfunction is associated with poor prognosis. Whether MitraClip improves clinical outcomes in this patient population remains controversial. Enhanced digital features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.10265168.

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