ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
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]
Anatol J Cardiol. 2022; 26(11): 802-809 | DOI: 10.5152/AnatolJCardiol.2022.1665

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

Changgan Chen, Beibei Xi, Qiufeng Deng, Xinyuan Zhang, Weicheng Lin, Liangwan Chen, ZhiHuang Qiu
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fujian, China; Key Laboratory of Cardio-Thoracic Surgery Fujian Medical University, Fujian Province University, Fujian, China

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.

Keywords: TAVI, SAVR, aortic stenosis, meta-analysis, low risk

Changgan Chen, Beibei Xi, Qiufeng Deng, Xinyuan Zhang, Weicheng Lin, Liangwan Chen, ZhiHuang Qiu. 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

Corresponding Author: ZhiHuang Qiu
Manuscript Language: English


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