Comparison of late mortality after transcatheter aortic valve implantation versus surgical aortic valve replacement: Insights from a meta-analysis

Abstract

TAVI conferred similar late all-cause mortality compared to SAVR in a meta-analysis of RCT but had worse outcomes in a meta-analysis of PSM.

Comparison of transcatheter versus surgical aortic valve implantation in high-risk patients: A nationwide study in France

“…This increase in mortality with TAVI compared to SAVR is consistent with our findings and has been recently emphasized in a meta-analysis of studies that used PSM. 8 The magnitude of the mortality-increase after TAVI compared to SAVR raises the question on the comparability of TAVI and SAVR cohorts matched using PSM and will be further discussed. However, we believe that the systematic presence of unidentified confounders within healthcare databases used across different country settings is unlikely.…”

“…4,5,7 Conversely, evidence from realworld data indicate a better outcome with surgery compared to TAVI. 8 Overall, the largest reported cohorts have a follow-up limited to one to three years in maximum 9,10 which is insufficient to provide a long-term view after aortic valve replacement (AVR).…”

Kidney dysfunction and short term all-cause mortality after transcatheter aortic valve implantation

“…Transcatheter aortic valve implantation (TAVI) has been proven to be the preferred procedure for patients with symptomatic aortic stenosis (AS) who do not qualify for surgery [1][2]. TAVI has been recently showed to present similar or even inferior all-cause mortality rates compared to surgery [3], thus representing a valid alternative also in the elderly [4]. Acute kidney injury (AKI) is one of the strongest predictors of mortality after TAVI and has been associated with worsened short-and long-term cardiovascular (CV) outcomes.…”

Message from “real-world” data of transcatheter versus surgical aortic valve replacement

“…Furthermore, these trials and procedures are often performed in experienced, high-volume centers. In fact, we previously reported worse mortality in TAVR compared to SAVR when the meta-analysis was performed with propensity-matched studies from "real-world" data but similar mortality when only randomized controlled studies were pooled (5). This observation raised a concern that TAVR may not confer similar benefit compared to SAVR outside the randomized clinical trial setting.…”