Transcatheter aortic valve replacement (TAVR) is a viable option in the treatment
of severe aortic stenosis in patients at high risk for surgery. We sought to further
investigate outcomes in patients at low to intermediate risk with aortic stenosis
who underwent surgical aortic valve replacement (SAVR) versus TAVR. We systematically
searched the electronic databases, MEDLINE, PubMed, EMBASE, and Cochrane for prospective
cohort studies of the effects of TAVR versus SAVR on clinical outcomes (30-day mortality,
all-cause mortality, stroke and myocardial infarction, major vascular complications,
paravalvular regurgitation, permanent pacemaker implantation, major bleeding, and
acute kidney injury). We identified 5 clinical studies, examining 1,618 patients in
the TAVR group and 1,581 patients in the SAVR group with an average follow-up of 1.05 years.
No difference in all-cause mortality, stroke, and myocardial infarction between the
2 approaches was found. TAVR was associated with higher rates of vascular complications,
permanent pacemaker implantation, and moderate or severe paravalvular regurgitation
(p <0.001 for all), whereas more major bleeding events were seen in the SAVR group
(p <0.001). In conclusion, TAVR was found to have similar survival and stroke rates
and lower major bleeding rates as compared with SAVR in patients at low or intermediate
surgical risk. However, SAVR was associated with less pacemaker placements and paravalvular
regurgitation rates.
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Article Info
Publication History
Published online: November 05, 2015
Accepted:
October 14,
2015
Received in revised form:
October 14,
2015
Received:
August 25,
2015
Footnotes
See page 257 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
