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Transcatheter Versus Surgical Aortic Valve Replacement in Patients at Low Surgical Risk: A Meta-Analysis of Randomized Trials and Propensity Score Matched Observational Studies

Friday, February 9, 2018

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Source Name: Catheterization Cardiovascular Interventions


Guy Witberg, Adi Lador, Dafna Yahav, Ran Kornowski

In this meta-analysis, the authors compare surgical aortic valve replacement (SAVR) with transcatheter aortic valve implantation (TAVI) in patients at low surgical risk. They included two randomized controlled trials and four propensity-matched studies for a total of almost 3500 patients. Short term mortality was similar between treatments, but intermediate follow-up (two years) showed higher mortality with TAVI versus SAVR (17.2% versus 12.7%, p=0.006).

Although these results should be taken with caution due to the largely non-randomized nature, it proves that we need to await the results of the currently ongoing low-risk trials (NOTION 2, PARTNER 3, and Medtronic TAVI low-risk trial) before we can recommend TAVI in low-risk patients.


In all heart operations,it is not only impottant to prove that a new procedure provides safe short term results simillar to a well established one but also to be able to provide comperable or even better results on the long term.

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