Systematic review and meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis

摘要: Background: Transcatheter aortic valve implantation (TAVI) has emerged as an acceptable treatment modality for patients with severe stenosis who are deemed inoperable by conventional surgical replacement (AVR). However, the role of TAVI in potential candidates remains controversial. Methods: A systematic review was conducted using five electronic databases, identifying all relevant studies comparative data on versus AVR. The primary endpoint all-cause mortality. number periprocedural outcomes were also assessed according to Valve Academic Research Consortium definitions. Findings: Fourteen quantitatively and included meta-analysis, including two randomized controlled trials eleven observational studies. Results indicated no significant differences between AVR terms cardiovascular related mortality, stroke, myocardial infarction or acute renal failure. subgroup analysis identified a higher combined incidence stroke transient ischemic attacks group compared group. found be associated significantly vascular complications, permanent pacemaker requirement moderate regurgitation. underwent more likely experience major bleeding. Both modalities appeared effectively reduce transvalvular mean pressure gradient. Conclusions: available at risk showed that adverse such mortality similar modalities. Evidence current literature is limited inconsistent patient selection criteria, heterogeneous definitions clinical endpoints relatively short follow-up periods. indications should therefore until long-term become available.