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Transcatheter vs. surgical aortic valve replacement in patients with aortic stenosis and chronic kidney disease: a

Maneeth Mylavarapu1, Israel Garcia2, Niharika Tanwar3

  • 1Department of Public Health, Adelphi University, NY, USA.

Annals of Medicine and Surgery (2012)
|September 3, 2025
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) shows better outcomes than Surgical aortic valve replacement (SAVR) for patients with aortic stenosis and chronic kidney disease, including lower mortality and fewer complications. However, TAVR increases risks for pacemaker implantation and vascular issues.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Interventional Cardiology

Background:

  • Aortic stenosis (AS) management involves Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement (SAVR).
  • Limited data exist on postoperative outcomes for AS patients with co-existing Chronic Kidney Disease (CKD).

Purpose of the Study:

  • To compare the postoperative clinical outcomes of TAVR versus SAVR in patients diagnosed with AS and CKD.

Main Methods:

  • A systematic literature search was performed following PRISMA guidelines across PubMed, EMBASE, Scopus, and Google Scholar.
  • Included studies compared TAVR and SAVR clinical outcomes specifically in patients with CKD.
  • Meta-analysis of 23 studies involving 69,017 patients.

Main Results:

  • TAVR was associated with significantly lower in-hospital mortality (OR 0.54), acute kidney injury (AKI) (OR 0.41), AKI requiring dialysis (OR 0.66), and overall postoperative complications (OR 0.34) compared to SAVR.
  • TAVR also showed a significant reduction in AKI incidence (P < 0.00001) and postoperative complications (P < 0.0001).
  • Conversely, TAVR had significantly higher odds of permanent pacemaker implantation (PPI) (OR 2.69) and major vascular complications (OR 2.56) than SAVR.

Conclusions:

  • In patients with AS and CKD, TAVR demonstrates superior outcomes regarding in-hospital mortality, AKI incidence, and postoperative complications compared to SAVR.
  • TAVR is linked to increased risks of PPI and major vascular complications, necessitating individualized risk assessment.
  • TAVR represents a favorable alternative to SAVR for carefully selected CKD patients with AS.
Abstract

Keywords:
SAVRTAVRacute kidney injuryall-cause mortalitychronic kidney diseasemeta-analysis

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