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Evidence summaries

Tavi Versus Open Surgery for Valve Replacement in Aortic Stenosis

There appears to be no difference between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in all-cause mortality, stroke, or myocardial infarction. There appear to be fewer new atrial fibrillations but more pacemaker implantations with TAVI. Level of evidence: "B"

The quality of evidence is downgraded by imprecise results (few outcome events and wide confidence interval).

Summary

A Cochrane review [Abstract] 1 included 4 studies with a total of 2 818 subjects with severe aortic stenosis (AS) and low surgical risk. The benefits and harms of transcatheter aortic valve implantation (TAVI) were compared to surgical aortic valve replacement (SAVR).

Neither in short- or long-term outcomes, there were no significant differences between TAVI and SAVR in all-cause mortality, stroke, or myocardial infarction, although there were very few events. Fewer people had atrial fibrillation, acute kidney injury, and bleeding when they underwent TAVI compared with SAVR. TAVI increased the risk of permanent pacemaker implantation compared with SAVR.

Clinical comments

Note

Date of latest search:

References

  • Kolkailah AA, Doukky R, Pelletier MP et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis in people with low surgical risk. Cochrane Database Syst Rev 2019;(12):CD013319. [PubMed]

Primary/Secondary Keywords