A meta-analysis of 1-year outcomes of transcatheter versus surgical aortic valve replacement in low-risk patients with severe aortic stenosis
Aaqib H Malik1
Syed Zaid2
Hasan Ahmad2
Joshua Goldberg3
Tanya Dutta2
Cenap Undemir3
Martin Cohen2
Wilbert S.Aronow2
Steven L Lansman3
1.Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA2.Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA3.Section of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York, USA
摘要：Background Transcatheter aortic valve replacement (TAVR) for the treatment symptomatic severe aortic stenosis (AS) is indicated in patients with intermediate or higher surgical risk.Latest trials showed TAVR,and surgical aortic valve replacement (SAVR) perform similarly at l-year for the composite outcomes of mortality,stroke and rehospitalization.We performed a comprehensive meta-analysis to compare individual outcomes at 1-year for TAVR compared to SAVR in low-risk patients.Methods PubMed,Embase,and Cochrane central were searched for all the randomized controlled trials (RCTs) that reported l-year comparative outcomes of TAVR and surgical aortic valve replacement (SAVR).Our conclusions are based upon the random-effects model using DerSimonian-Laird estimator.Results Data from 4 trials and 2887 randomized patients showed that TAVR had lower rates of all-cause mortality,cardiovascular mortality,and atrial fibrillation compared to SAVR at l-year follow-up (P ＜ 0.05 for all).Also,TAVR was also associated with a significantly higher risk of permanent pacemaker implantation and moderate-severe paravalvular leak (P ＜ 0.05).Conclusions The latest randomised trial data demonstrates that in short-term,TAVR is safe and effective in reducing all-cause mortality or stroke.Longer follow-up of RCTs is needed to determine the durability of clinical benefits in TAVR over SAVR in low-risk patients.
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论文发表日期：2020-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 43-50 )
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