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Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic

Azka Latif1, Noman Lateef1, Muhammad Junaid Ahsan1

  • 1Department of Internal Medicine, Creighton University, Omaha, NE 68124, USA.

Journal of Cardiovascular Development and Disease
|September 15, 2020
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are options for severe aortic stenosis patients with prior surgery. TAVR showed fewer strokes and bleeding, with shorter hospital stays.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Interventional Cardiology

Background:

  • Increasing number of patients with severe aortic stenosis (AS) have undergone prior cardiac surgery.
  • Prior cardiac surgery is associated with increased risks for adverse outcomes during aortic valve replacement.

Purpose of the Study:

  • To compare clinical outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with severe AS and prior cardiac surgery.
  • Evaluate the impact of prior cardiac surgery on key clinical endpoints.

Main Methods:

  • Systematic literature search of PubMed, Embase, Google Scholar, and Scopus.
  • Included studies compared TAVR and SAVR in patients with prior cardiac surgery.
  • Analyzed endpoints: mortality, acute kidney injury (AKI), bleeding, stroke, procedure time, and hospital stay.

Main Results:

  • Seven studies with 8221 patients were analyzed.
  • TAVR demonstrated a lower incidence of stroke and bleeding complications compared to SAVR.
  • No significant differences were observed in AKI or all-cause mortality (30-day and 1-2-year) between TAVR and SAVR.
  • TAVR was associated with significantly shorter procedure times and hospital stays.

Conclusions:

  • Both TAVR and SAVR are viable options for patients with severe AS and prior coronary artery bypass graft surgery.
  • TAVR may offer advantages including reduced stroke and bleeding complications, alongside shorter hospitalizations.

Keywords:
SAVRTAVRin-hospital outcomesprior CABGredo-AVRshort-term outcomessurgical aortic valve replacementtranscatheter aortic valve replacement

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