Elmaraezy A, et al. – This study analyzed evidence on safety and efficacy of transcatheter aortic valve replacement (TAVR) compared to that of surgical aortic valve replacement (SAVR) in low–to–moderate surgical risk patients with aortic stenosis (AS). TAVR can be an acceptable alternative to SAVR in low–to–moderate risk patients with AS as TAVR had lower risk of life–threatening complications, and offered mortality rates comparable to SAVR.

Methods

• Researchers performed a systematic search of five authentic databases that retrieved 11 eligible studies (20,056 patients).
• They pooled relevant data as risk ratios (RRs) or standardized mean differences (SMD), with their 95% confidence interval, using Comprehensive Meta-Analysis and RevMan software for windows.

Results

• Researchers observed that at one-year of follow-up, the pooled effect-estimates revealed no significant difference between TAVR and SAVR groups in terms of all-cause mortality (RR 1.02, 95% CI [0.83, 1.26], stroke (RR 0.83, 95%CI [0.56, 1.21]), myocardial infarction (RR 0.82, 95% CI [0.57, 1.19]), and length of hospital stay (SMD -0.04, 95% CI [-0.34, 0.26]).
• Findings demonstrated that the incidence of major bleeding (RR 0.45, 95% CI [0.24, 0.86]) and acute kidney injury (RR 0.52, 95% CI [0.30, 0.88]) was significantly lower in the TAVR group, compared to the SAVR group.
• However, data reported that TAVR was associated with a higher risk of permanent pacemaker implantation (RR 2.57, 95% CI [1.36, 4.86]), vascular-access complications at 1 year (RR 1.99, 95%CI [1.04, 3.80]), and paravalvular aortic regurgitation at 30 days (RR 3.90, 95% CI [1.25, 12.12]), compared to SAVR.