Transcatheter vs Surgical Aortic Valve Replacement for Aortic Stenosis in Low-Intermediate Risk Patients: A Meta-analysis

Transcatheter versus surgical aortic valve replacement in patients at low surgical risk: A meta‐analysis of randomized trials and propensity score matched observational studies

“…Our results represent the first comprehensive meta‐analysis of TAVR versus SAVR in this patient population, a previous analysis by Tam et al , was a subgroup analysis performed as part of a larger meta‐analysis of intermediate and low risk patients, differs from our study in several aspects: It did not assess any outcomes other than short‐term mortality (with results similar to ours). Smaller sample size—although both analyses included six studies overall, Tam et al did not include the study with the largest sample size ( n = 1,710) included in our analysis by Freker et al , which was classified by them as intermediate risk, although the average EuroScore for the TAVR and SAVR arms were 4.2 and 6.4, respectively (as it also appears in the data by Tam et al), as well as the subgroup analysis of the study by Piazza et al . Tam et al did include the study by Repossini et al which we excluded for using only sutureless valves in the SAVR arm, and the study by Castrodeza et al , whose average Euroscore is in the low risk stratum (9.4 and 9.3 in the TAVR and SAVR arms, respectively) but it's STS scores are in the intermediate risk stratum (4.6 and 4.3), and was therefore excluded from our analysis.…”

“…Our results represent the first comprehensive meta-analysis of TAVR versus SAVR in this patient population, a previous analysis by Tam et al [13], was a subgroup analysis performed as part of a larger meta- A meta-analysis dedicated to low risk patients by Arora et al [14] did not examine outcomes beyond the short-term, and again, had a considerably smaller sample size compared to ours-2,252 compared to 3,484 patients.…”

Transcatheter valve‐in‐valve versus redo surgical aortic valve replacement for the treatment of degenerated bioprosthetic aortic valve: A systematic review and meta‐analysis

“…Nonetheless, the finding of no differences on some of our outcomes (i.e. rates of major bleeding and vascular complications) may be the result of an underpowered analysis; differences were seen in these outcomes in recent large RCTs comparing TAVR to SAVR . As mentioned previously, there was no RCT evidence, only retrospective observational studies.…”

Relationship between the membranous septum and the virtual basal ring of the aortic root in candidates for transcatheter implantation of the aortic valve

“…An appreciation of its anatomy in the living patient is necessary for those performing invasive procedures involving the aortic root. In this regard, transcatheter implantation of the aortic valve (TAVI) is now recognized as an optimal procedure for patients with severe aortic stenosis (Leon et al ; Smith et al ), with its indications now expanding to include patients deemed to be at lower risk (Leon et al ; Tam et al ). When compared with surgical replacement, however, the increased risk of injury to the atrioventricular conduction axis remains a significant concern (Siontis et al ; Nazif et al ; Auffret et al ).…”