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Comparative Analysis of Cerebrovascular Events in Transcatheter and Surgical Aortic Valve Replacement- Systematic Review and Meta-analysis of Randomized Trials.

Comparative Analysis of Cerebrovascular Events in Transcatheter and Surgical Aortic Valve Replacement- Systematic Review and Meta-analysis of Randomized Trials.
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Mohananey D, Sengodan P, Banerjee K, Kumar A, Jobanputra Y, Sankaramangalam K, Krishnaswamy A, Mick S, White JM, Svensson LG, Kapadia SR,


Mohananey D, Sengodan P, Banerjee K, Kumar A, Jobanputra Y, Sankaramangalam K, Krishnaswamy A, Mick S, White JM, Svensson LG, Kapadia SR, (click to view)

Mohananey D, Sengodan P, Banerjee K, Kumar A, Jobanputra Y, Sankaramangalam K, Krishnaswamy A, Mick S, White JM, Svensson LG, Kapadia SR,

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EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2018 02 13() pii EIJ-D-17-00732
Abstract
AIMS
Transcatheter aortic valve replacement (TAVR) has become the procedure of choice for inoperable patients and a safe alternative to surgical aortic valve replacement (SAVR) among moderate risk patients. We used meta-analysis to compare the incidence of cerebrovascular events amongst patients undergoing TAVR and SAVR in randomized controlled trials (RCT).

METHODS AND RESULTS
Our search revealed 5 RCTs published between 2011 and 2017 with a total of 5414 patients. Data were summarized as Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CI). The risk of major stroke [RR 0.89 (95% CI 0.53-1.51)], all strokes [RR 0.85(95% 0.59-1.22)] and all cerebrovascular events [RR 0.94 (95% CI 0.75-1.17) was comparable between patients undergoing TAVR and SAVR at 30 days of follow up. The risk of all all strokes [RR 0.92(95% CI 0.69-1.22)], major stroke [RR 0.92(95% CI 0.62-1.37)] and all cerebrovascular events [RR 1.03(95% CI 0.79-1.33)] were comparable between TAVR and SAVR at 1 year of follow up. The incidence of major stroke [RR 1.02 (95% CI 0.64-1.61), all strokes [RR 1.12 (95% CI 0.78-1.62)] and all cerebrovascular events [RR 1.23 (95% CI 0.91-1.66)] was comparable between TAVR and SAVR between 30 days and 1 year of follow-up.

CONCLUSIONS
In our meta-analysis of RCTs comparing TAVR and SAVR, we show comparable risk of major stroke, all stroke and all cerebrovascular events.

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