The Anatolian Journal of Cardiology
Meta Analysis

Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year Follow-Up

1.

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fujian, China

2.

Key Laboratory of Cardio-Thoracic Surgery Fujian Medical University, Fujian Province University, Fujian, China

Anatol J Cardiol 2022; 26: 802-809
DOI: 10.5152/AnatolJCardiol.2022.1665
Read: 119 Downloads: 76 Published: 01 November 2022

Background: Previous studies have shown that transcatheter aortic valve implantation is the best alternative therapy to surgical aortic valve replacement in high-risk surgical patients with aortic stenosis. However, it is not clear whether transcatheter aortic valve implantation can be utilized in low-risk surgical patients with aortic stenosis. This studyaimed to evaluate the safety and efficacy of transcatheter aortic valve implantation in low-risk patients.

Methods: From the outset of our initiative until April 2022, PubMed, EMBASE, and the Cochrane database were thoroughly searched, yielding the selection of 3 randomized controlled trials including 2644 patients with aortic stenosis, to assess outcome measures at distinct follow-up time.

Results: The mean Society of Thoracic Surgeons Predicted Risk of Mortality score of patients was 2.2. At the 30-day and 1-year follow-up, transcatheter aortic valve implan- tation was associated with a lower incidence of all-cause mortality, cardiovascular mor- tality, acute kidney injury (stage 2 or 3), life-threatening or significant bleeding, and new atrial fibrillation but an increased risk of permanent pacemaker implantation. At the 2-year follow-up, transcatheter aortic valve implantation only had an advantage in new atrial fibrillation (relative risk, 0.27; 95% CI, 0.14-0.51; P < .0001), with no significant differ- ence in all-cause mortality or cardiovascular mortality.

Conclusions: For low-risk surgical patients with aortic stenosis, compared to surgical aortic valve replacement, transcatheter aortic valve implantation was associated with lower all-cause mortality at 30-day follow-up and lower cardiovascular mortality at 1-year follow-up. Except for the advantages in new atrial fibrillation, transcatheter aor- tic valve implantation had no significant impact on mortality at 2-year follow-up.

Cite this article as: Chen C, Xi B, Deng Q, et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement in low-risk patients: A meta-analysis based on a 2-year follow-up. Anatol J Cardiol. 2022;26(11):802-809.

Files
ISSN 2149-2263 EISSN 2149-2271