Transcatheter aortic valve implantation versus surgical aortic valve replacement: A meta-analysis of randomized controlled trials.
BACKGROUND
Transcatheter aortic valve implantation (TAVI) has become a widely utilized method of treatment of severe aortic valve stenosis. The present meta-analysis included all published relevant randomized controlled trials (RCTs) and aimed to compare the safety and efficacy of TAVI compared to surgical aortic valve replacement (AVR).


METHODS
Nine electronic databases were comprehensively searched. Eligible studies were required to be randomized controlled trials which reported comparative endpoints on both TAVI and AVR.


RESULTS
Five published RCTs were included in the meta-analysis. A total of 3828 patients were studied. The overall mortality and stroke rates at 30days and 1year were not significantly different between TAVI and AVR. Patients undergoing TAVI were more likely to experience vascular complications, aortic regurgitation and permanent pacemaker insertion, however, they were less likely to encounter acute renal failure and major haemorrhage.


CONCLUSIONS
The data suggest that TAVI is a safe and efficacious alternative to surgical aortic valve replacement in judiciously selected patients.
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Department of Cardiology, St George Hospital, Sydney, Australia.
Praveen
P
Indraratna
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia.
David H
DH
Tian
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Department of Cardiothoracic, Royal Prince Alfred Hospital, Sydney, Australia.
Tristan D
TD
Yan
Department of Cardiothoracic Surgery, St George Hospital, Sydney, Australia.
Mathew P
MP
Doyle
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Department of Cardiothoracic Surgery, St George Hospital, Sydney, Australia. Electronic address: drchriscao@gmail.com.
Christopher
C
Cao
D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000209:etiology*; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
Aortic stenosis; Aortic valve; Meta-analysis; Systematic review; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement