Aortic-Valve Replacement in Patients at Low or Intermediate Surgical Risk: Which Intervention Is Best?

A meta-analysis of randomized controlled trials shows that mortality is lower with transfemoral TAVR than surgical valve replacement in these patients with aortic stenosis.

The value of transcatheter aortic-valve replacement (TAVR) for patients with severe aortic stenosis at low and intermediate surgical risk remains unclear. These researchers performed a meta-analysis on four randomized trials comparing TAVR and surgical aortic-valve replacement (SAVR) in patients at intermediate and lower operative risk; a total of 3179 patients were included. The Partner 2A trial provided 2032 patients, with the balance from the other three studies.

Median follow-up was 2 years. Compared with SAVR, TAVR was associated with a lower risk for acute kidney injury (relative risk [RR], 0.48), bleeding (RR, 0.39), and new-onset atrial fibrillation (RR, 0.43). It also showed a trend toward a lower risk for stroke. Hospital stays wer…

Reviewing Author

Pascal Meier, MD

Disclosures

Editorial BoardsOpen Heart

Leadership Positions in Professional SocietiesEuropean Society of Cardiology (Communication Committee); European Association of Percutaneous Cardiovascular Interventions (Chair, Web & Communication Committee)

Pascal Meier, MD

Disclosures

Editorial BoardsOpen Heart

Aortic-Valve Replacement in Patients at Low or Intermediate Surgical Risk: Which Intervention Is Best?

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Reviewing Author