Severe aortic valve stenosis (AVS) is a condition characterized by the narrowing of the valve in the aorta. Transcatheter and surgical aortic valve replacements are commonly used to treat patients with AVS. This study aims to compare the effects of transcatheter aortic valve implantation (TAVI) and surgical replacement of an aortic valve (SAVR) in patients with severe AVS.

This was a systematic review and meta-analysis of 4 randomized trials of TAVI compared with SAVR in 3,179 patients with severe AVS with a mean perioperative risk of death <8%. The risk of bias for outcomes was assessed. The primary outcomes of the study were the clinical outcomes in patients who underwent TAVI vs. SAVR.

During a median follow-up of 2 years, transfemoral TAVI was associated with reduced mortality (risk difference –30), stroke (−20), life-threatening bleeding (−252), atrial fibrillation (−178), and acute kidney injury (−53). However, TAVI was linked with an increased short term aortic valve reintervention (+7), permanent pacemaker insertion (+134), and moderate or severe symptoms of heart failure (+18). When compared with SAVR, TAVI carried a higher risk of mortality (+57) and stroke (+45).

The research concluded that in patients with severe AVS, TAVI was associated with a higher risk of death and stroke when compared with SAVR.

Ref: https://www.bmj.com/content/354/bmj.i5130