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A meta-analysis of 1-year outcomes of transcatheter versus surgical aortic valve replacement in low-risk patients with severe aortic stenosis

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Journal of Geriatric Cardiology 2020年第1期17卷 43-50,I0008-I0010页

作者： Aaqib H Malik Syed Zaid Hasan Ahmad joshua goldberg Tanya Dutta Cenap Undemir Martin Cohen Wilbert S Aronow Steven L Lansman Department of Medicine Westchester Medical Center and New York Medical CollegeValhallaNYUSA Department of Cardiology Westchester Medical Center and New York Medical CollegeValhallaNYUSA Section of Cardiothoracic Surgery Department of SurgeryWestchester Medical CenterValhallaNew YorkUSA

Background Transcatheter aortic valve replacement(TAVR)for the treatment symptomatic severe aortic stenosis(AS)is indicated in patients with intermediate or higher surgical *** trials showed TAVR,and surgical aortic valve replacement(SAVR)perform similarly at 1-year for the composite outcomes of mortality,stroke and *** performed a comprehensive meta-analysis to compare individual outcomes at 1-year for TAVR compared to SAVR in low-risk *** Pub Med,Embase,and Cochrane central were searched for all the randomized controlled trials(RCTs)that reported 1-year comparative outcomes of TAVR and surgical aortic valve replacement(SAVR).Our conclusions are based upon the random-effects model using Der Simonian-Laird *** 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 1-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 *** follow-up of RCTs is needed to determine the durability of clinical benefits in TAVR over SAVR in low-risk patients.

关键词： Aortic stenosis Low surgical risk Meta-analysis Transcatheter aortic valve replacement

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