The International Society for Minimally Invasive Cardiothoracic Surgery Expert Consensus Statement on Transcatheter and Surgical Aortic Valve Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of Randomized and Propensity-Matched Studies.

Thourani, Vinod H; Edelman, J James; Holmes, Sari D; Nguyen, Tom C; Carroll, John; Mack, Michael J; Kapadia, Samir; Tang, Gilbert H L; Kodali, Susheel; Kaneko, Tsuyoshi; Meduri, Christopher U; Forcillo, Jessica; Ferdinand, Francis D; Fontana, Gregory; Suwalski, Piotr; Kiaii, Bob; Balkhy, Husam; Kempfert, Joerg; Cheung, Anson; Borger, Michael A; Reardon, Michael; Leon, Martin B; Popma, Jeffrey J; Ad, Niv

Date

2021-01-25

Journal

Innovations (Philadelphia, Pa.)

Publisher

SAGE Publications Inc.

Type

Article

Metadata

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See at

https://doi.org/10.1177/1556984520978316

Abstract

Early mortality was lower in TAVR compared to SAVR in RCTs, but not propensity-matched studies in low-risk cohorts (0.66% vs 1.5%; odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20 to 0.98, I2 = 0%). No difference in mortality between TAVR and SAVR was identified in intermediate-risk patients at early or later time points. Incidence of perioperative stroke in 3 low-risk RCTs was significantly lower in TAVR (0.4%) than SAVR (1.4%; OR = 0.33, 95% CI 0.13 to 0.81, I2 = 0%). There was no difference in stroke for intermediate-risk patients between TAVR and SAVR. The expert panel of cardiologists and cardiac surgeons provided recommendations for TAVR and SAVR in various clinical scenarios.