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TAVR vs. SAVR in Patients With Severe Aortic Stenosis and Chronic Kidney Disease Undergoing Dialysis: A Comprehensive

Maneeth Mylavarapu1,2, Madiha Kiyani3, Niharika Tanwar4

  • 1Department of Cardiology, Endeavor Health Cardiovascular Institute, Endeavor Health Glenbrook Hospital, Glenview, Illinois, 60026, USA.

Cardiology Research and Practice
|June 22, 2026
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) shows better early outcomes for dialysis patients with severe aortic stenosis (AS) compared to surgical aortic valve replacement (SAVR). TAVR reduces in-hospital mortality and length of stay, though pacemaker implantation is more frequent.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Management of severe aortic stenosis (AS) in patients with chronic kidney disease (CKD) on dialysis is complex.
  • Both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are options, but comparative outcomes are unclear in this high-risk group.

Purpose of the Study:

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

Main Methods:

  • A systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched PubMed, EMBASE, Scopus, and Google Scholar for studies comparing TAVR and SAVR in severe AS patients with CKD on dialysis.
  • Included ten retrospective studies with 28,625 patients (14,625 TAVR, 14,000 SAVR).

Main Results:

  • TAVR was associated with significantly lower in-hospital mortality (OR 0.49; p=0.01) and shorter length of stay (LOS) (SMD -2.59; p≤0.04).
  • The TAVR group had significantly higher odds of permanent pacemaker implantation (OR 2.25; p<0.00001).

Conclusions:

  • TAVR demonstrates a favorable early safety profile in severe AS patients with CKD on dialysis.
  • Lower in-hospital mortality and shorter LOS suggest improved early recovery with TAVR in this population.
Abstract

Keywords:
chronic kidney diseasedialysisend stage renal diseasemeta-analysissevere aortic stenosissurgical aortic valve replacementtranscatheter aortic valve replacement

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