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The purpose of this meta–analysis is to compare the post–procedural outcomes of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic stenosis.
Seventeen studies (n=4710) comparing TAVI (n=2288) and SAVR (n=2422) were included. End points were baseline logistic EuroScore, all–cause mortality, cardiovascular mortality, myocardial infarction, stroke, transient ischemic attack, major bleeding and major vascular events. The odds ratio (OR) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance.
No significant difference was found between SAVR and TAVI for baseline logistic EuroScore (p=0.07), all–cause mortality at 30 days (p=0.92) and average 69 weeks (p=0.11) (Figure 1), cardiovascular mortality (p=0.54), myocardial infarction (p=0.59), stroke (p=0.4) and transient ischemic attacks (p=0.85). Compared to SAVR, TAVI had significantly lower major bleeding (OR:1.78, CI:1.35–2.33, p<0.00001) and higher major vascular complications (OR:0.42, CI:0.17–1, p=0.05).
Our meta–analysis of 17 studies with 4710 matched–risk propensity population showed that TAVI has similar cardiovascular and all–cause mortality to SAVR at average 69 weeks follow–up. TAVI is superior to SAVR for major bleeding complications and non–inferior to SAVR for post–procedural cerebrovascular events, myocardial infarctions and major vascular events.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: TAVR III: Meta–Analyses, Costs and International and National Trends in TAVR
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1196–75
- 2013 American College of Cardiology Foundation