Valvular heart diseaseA Meta-Analysis of Mortality and Major Adverse Cardiovascular and Cerebrovascular Events Following Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis
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Methods
We performed this meta-analysis in accordance with the Meta-Analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements for reporting systematic reviews. General guidelines of the Cochrane Handbook for Systematic Reviews of Interventions, version 5.0.2, were used in developing the method, and the meta-analysis was conducted in adherence to these guidelines.6 We searched the National Library of Medicine's PubMed database,
Results
The search process is explained in Figure 1. Only 17 studies met the inclusion criteria and were included in our analysis. Overview and baseline patient characteristics are listed in Table 1. Smith et al8 published 1-year outcomes and Kodali et al9 published 2-year outcomes of same patients from the Placement of Aortic Transcatheter Valves (PARTNER) trial. Ten studies had matched propensity groups between TAVI and SAVR,8, 9, 10, 11, 12, 13, 14, 15, 16, 17 whereas in 6 studies, TAVI was
Discussion
Studies have shown conflicting results in mortality after TAVI compared with SAVR. However, our meta-analysis of these studies demonstrated that TAVI and SAVR have similar all-cause 30-day mortality despite higher risk patients in the TAVI group, which suggests that periprocedural mortality does not differ between TAVI and SAVR. Long-term all-cause mortality and cardiovascular mortality were also similar between TAVI and SAVR in our meta-analysis in a matched-risk population on the basis of
Disclosures
The authors have no conflicts of interest to disclose.
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