Comparison of TAVR with SAVR on clinical outcomes in patients with aortic stenosis: a systematic review and meta-analysis.

Abstract

Introduction: The advances and studies carried out in the area have shown that patients with aortic stenosis (AS) undergoing surgical valve replacement (SAVR) did not have encouraging outcomes. This study aims to compare the different risk factors in patients with AS undergoing transcatheter aortic valve replacement (TAVR) vs. SAVR, respectively, to offer options and more favorable results based on the results obtained in patients with these conditions.

Methods: The study was in accordance with the PRISMA guidelines. Studies comparing outcomes of surgical and transaortic catheter valve replacements in adults were included. Descriptive statistics, binary random effects, and continuous random effects were used. I ² statistics were used to assess for heterogeneity. A P-value ≤0.05 was considered statistically significant.

Results: In total, eight studies with 18 671 patients were included in our study. All-cause mortality (2.48% vs. 3.03%), major bleeding (11.25% vs. 31.05%), and atrial fibrillation (2.39% vs. 50.42%) were lower in TAVR compared to SAVR. Furthermore, odds of all-cause mortality (odds ratio [OR]: 0.79; 95% CI: 0.63-1.00; P = 0.05), stroke (OR: 0.71; 95% CI: 0.58-0.87; P = 0.0008), and acute kidney injury (AKI) (OR: 0.38; 95% CI: 0.29-0.49; P < 0.00001) were lower in the TAVR group compared to the SAVR group.

Conclusion: TAVR is superior to SAVR and significantly reduces the risks associated with all-cause mortality, stroke, AKI, and other clinical outcomes. Furthermore, additional research is regarding the long-term effects of transcatheter aortic valve replacement.