TAVI, SAVR have comparable short-, midterm safety
Transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) have comparable safety in low-risk surgical patients, reports a new meta-analysis.
Accessing the databases of Google Scholar, the Cochrane Library and PubMed, researchers retrieved eight eligible studies, of which three were randomized controlled trials. The cumulative sample included 6,686 patients, in whom the primary outcomes of short-term mortality, stroke and/or transient ischaemic attacks, as well as midterm outcomes, were assessed.
Patients in the TAVI arm had better short-term survival, though the difference failed to reach statistical significance (risk ratio [RR], 0.68, 95 percent CI, 0.45–1.03; p=0.07). Seven studies were included in the pooled analysis for this outcome.
Results from six studies similarly showed that TAVI and SAVR were also comparable in terms of short-term stroke/transient ischaemic attacks (RR, 0.76, 0.52–1.13; p=0.18).
Midterm outcomes, occurring 1–3 years after the procedure, were similarly statistically similar between SAVR and TAVI (mortality: five studies; RR, 0.89, 0.54–1.47; p=0.65; stroke/transient ischaemic attacks: four studies; RR, 1.04, 0.55–1.97; p=0.9).
In terms of periprocedural events, however, TAVI resulted in significantly lower risks of new-onset atrial fibrillation, acute kidney injury and bleeding. On the other hand, the odds of vascular complications and moderate aortic regurgitation were higher.