Meta‐analysis of transfemoral <scp>TAVR</scp> versus surgical aortic valve replacement

Arora, Sameer; Vaidya, Smita; Strassle, Paula D.; Misenheimer, Jacob A.; Rhodes, Jeremy A.; Ramm, Cassandra J.; Wheeler, Evan N.; Caranasos, Thomas G.; Cavender, Matthew A.; Vavalle, John P.

doi:10.1002/ccd.27357

Cited by 18 publications

(11 citation statements)

References 30 publications

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“…similar 30-day and 1-year mortality rates, but with secondary outcomes similar to that presented in this meta-analysis; atrial fibrillation, AKI, and myocardial infarction were more common with SAVR, whereas transfemoral TAVI had more vascular complications and PPI rates. 12 Previous trials showed similar survival benefits between the two modalities in high-risk patients for up to 5 years. 2 Published randomized control trials comparing the two approaches for intermediate-risk patients include the PARTNER IIA trial and the SURTAVI trial.…”

Section: Discussion Commentmentioning

confidence: 92%

Three-Year Survival Comparison between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients

Siordia

Loera

Scanlon

et al. 2018

Innovations�(Phila)

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Transcatheter aortic valve implantation is a suitable therapeutic intervention for patients deemed inoperable or high risk for surgical aortic valve replacement. Current investigations question whether it is a suitable alternative to surgery for intermediate- and low-risk patients. The following meta-analysis presents a comparison between transcatheter versus surgical aortic valve replacement in patients that are intermediate and low risk for surgery. Articles were collected via an electronic search using Google Scholar and PubMed. Articles of interest included studies comparing the survival of intermediate- and low-risk patients undergoing transcatheter aortic valve implantation to those undergoing surgical aortic valve replacement. Primary end points included 1-, 2-, and 3-year survival. Secondary end points included postintervention thromboembolic events, stroke, transient ischemic attacks, major vascular complications, permanent pacemaker implantation, life-threatening bleeding, acute kidney injury, atrial fibrillation, and moderate-to-severe aortic regurgitation. Six studies met the criteria for the meta-analysis. One- and two-year survival comparisons showed no difference between the two interventions. Surgical aortic valve replacement, however, presented with favorable 3-year survival compared with the transcatheter approach. Transcatheter aortic valve implantation had more major vascular complications, permanent pacemaker implantation, and moderate-to-severe aortic regurgitation rates compared with surgery. Surgical aortic valve replacement presented more life-threatening bleeding, acute kidney injury, and atrial fibrillation compared with a transcatheter approach. There was no statistical difference between the two approaches in terms of thromboembolic events, strokes, or transient ischemic attack rates. Surgical aortic valve replacement presents favorable 3-year survival rates compared with transcatheter aortic valve implantation.

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Section: Discussion Commentmentioning

confidence: 92%

Three-Year Survival Comparison between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients

Siordia

Loera

Scanlon

et al. 2018

Innovations�(Phila)

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“…More so, prompt valve intervention was required to facilitate operative resection of the adnexal mass. TAVR is an excellent method of providing a safe and effective treatment for this patient with low morbidity/mortality and short recovery time ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Massive TAVR

et al. 2020

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A 65-year-old woman with a large adnexal mass was found to have severe bicuspid aortic valve stenosis. Transcatheter aortic valve replacement was chosen rather than surgical aortic valve replacement because of concerns over risks. We demonstrate the value of pre-operative transcatheter aortic valve replacement before prompt noncardiac surgery. Furthermore, it illustrates some useful bailout techniques in this challenging scenario. ( Level of Difficulty: Intermediate. )

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“…Previous meta-analyses [4,[23][24][25][26][27][28][29][30] indicated no difference in 1-year mortality between TAVI and SAVR. However, these meta-analyses [4,[23][24][25][26][27][28][29][30] (including neither the Evolut Low Risk trial [5] nor the PARTNER 3 trial [6]) were quite different from the present metaanalysis (including both the Evolut Low Risk trial [5] and the PARTNER 3 trial [6]). Longer (≥2-year)-term outcomes after TAVI versus SAVR in RCTs have still been inadequate.…”

Section: Figmentioning

confidence: 99%

Mortality after transcatheter versus surgical aortic valve replacement: an updated meta-analysis of randomised trials

et al. 2020

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Background To determine whether transcatheter aortic valve implantation (TAVI) improves early (30-day) and midterm (1-year) mortality compared with surgical aortic valve replacement (SAVR), we performed an updated meta-analysis of all the currently available randomised controlled trials (RCTs). Methods To identify all RCTs providing both 30-day and 1-year mortality after TAVI versus SAVR, PubMed and ClinicalTrials.gov were searched up to and including July 2019. A risk difference (RD) and its 95% confidence interval were generated using data of prespecified outcomes in both the TAVI and SAVR groups. Study-specific estimates were pooled using inverse variance-weighted averages of RDs in the random-effects model. Results We identified seven eligible high-quality RCTs including a total of 7631 as-treated patients. Pooled analyses demonstrated significantly lower 30-day (RD-0.60%; p = 0.046) and 1-year all-cause mortality (RD Electronic supplementary material The online version of this article (

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Meta‐analysis of transfemoral TAVR versus surgical aortic valve replacement

Abstract: TF-TAVR is associated with lower 30-day risks of myocardial infarction compared to SAVR. Further studies are required to investigate the role of myocardial injury on overall TF-TAVR outcomes.

Cited by 18 publications

References 30 publications

Three-Year Survival Comparison between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients

Three-Year Survival Comparison between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients

Massive TAVR

Mortality after transcatheter versus surgical aortic valve replacement: an updated meta-analysis of randomised trials

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