Why is this study important?

• TAVR (transcatheter aortic valve replacement) is less invasive compared to SAVR (surgical aortic valve replacement) in the treatment of severe aortic stenosis.
• TAVR appears to be effective and safe, but its long-term benefits and outcomes as compared to SAVR are unclear at the current time.

 
What question was this study supposed to answer?

• A meta-analysis of randomized control trials was performed comparing the long-term outcomes of patients who underwent TAVR versus those who underwent SAVR.
• The trials were grouped into high-risk, intermediate-risk, and low-risk categories as per surgical risk. The TAVR arm was further categorized as self-expanding valve and balloon-expandable valve categories.

 
What did the study show?

• Seven trials (n=7785 patients) were included in the meta-analysis. Mean trial follow-up was 5.76 ± 0.073 years.
• There was no significant difference in death or disabling stroke in TAVR patients as compared to SAVR patients (HR 1.02, 95% CI 0.93–1.11, p=0.70).
• There were no significant differences in mortality between the TAVR patients and SAVR patients.
• TAVR resulted in higher pacemaker implantation (self-expandable valves had a significantly higher rate than balloon-expandable valves) and moderate-to-severe paravalvular leaks compared to SAVR.
• The self-expanding TAVR valves were associated with lower valve gradients but higher pacemaker implantation rates than balloon-expandable TAVR valves.
• The above results were consistent across all surgical risk (high risk, intermediate risk, and low risk) categories.