Original articleAdult cardiacA Meta-Analysis of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement
Section snippets
Search Strategy
All randomized controlled trials and adjusted observational comparative studies of TAVI vs AVR enrolling patients with AS were identified using two-level search strategy. First, public-domain databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, were searched through October 2012 using Web-based search engines (PubMed and OVID). Keywords included percutaneous, transcatheter, transluminal, transarterial, transfemoral, transsubclavian, transaxillary,
Search Results
Our comprehensive search identified only two randomized controlled trials (Placement of Aortic Transcatheter Valves [PARTNER] 7, 8 and A Prospective, Randomised Trial of Transapical Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement in Operable Elderly Patients With Aortic Stenosis [STACCATO] [9]) and 15 adjusted observational comparative studies 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 of TAVI vs AVR enrolling high-risk (∼10 to > 30 of EuroSCORE)
Early and Late Mortality Rates
It never would be surprising that early mortality rates after TAVI are compatible with those after AVR because observed TAVI mortality rates are similar to predicted AVR mortality rates not using the EuroSCORE but using the STS-PROM [3]. The EuroSCORE has been well known to overestimate the risks for AVR 26, 27, 28, 29; however, the STS-PROM is superior to the logistic EuroSCORE in predicting death in high-risk patients with severe AS [30]. Our previous pooled analysis [3] of 26 single-arm
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