Trends in Transcatheter Versus Surgical Aortic Valve Replacement Outcomes in Patients With Low‐Surgical Risk: A Systematic Review and Meta‐Analysis of Randomized Trials

Abstract

Background Limited data exist on long‐term outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). This meta‐analysis aims to elucidate outcome trends following TAVR versus SAVR in patients with severe aortic stenosis and low‐surgical risk. Methods and Results A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases from inception until May 2024, to identify studies comparing TAVR versus SAVR in patients with low‐surgical risk (Society of Thoracic Surgeons predicted risk of mortality score 1‐year follow‐ups. TAVR was associated with a significantly lower risk of cardiovascular mortality, disabling stroke, rehospitalization, new‐onset atrial fibrillation, and a higher risk of permanent pacemaker implantation compared with SAVR during the 30‐day follow‐up. Conclusions TAVR was associated with a lower risk of all‐cause mortality within the first year of post‐procedural follow‐up compared with SAVR. However, the risk of all‐cause mortality was similar in >1‐year follow‐ups.

Keywords

• aortic stenosis
• low surgical risk
• mortality
• surgical aortic valve replacement
• transcatheter aortic valve replacement