Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: A Systematic Review of Long-Term Outcomes

TL;DR

This paper compares long-term outcomes of two heart valve replacement methods in low-risk patients, finding similar survival but differing complication rates.

Contribution

The study provides a systematic review comparing long-term outcomes of TAVR and SAVR in low-risk patients, highlighting variability in durability and re-intervention rates.

Findings

Randomized studies show similar long-term survival and stroke rates between TAVR and SAVR.

Observational studies suggest worse late outcomes with TAVR compared to SAVR.

TAVR is associated with fewer postoperative complications but variable valve durability.

Abstract

The role of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) continues to expand, yet uncertainty remains regarding the long-term outcomes in low-risk populations compared with surgical aortic valve replacement (SAVR). This systematic review examined long-term mortality, stroke, postoperative complications, and valve durability across randomized and observational studies. Randomized data showed similar long-term survival and stroke rates between TAVR and SAVR, while observational studies suggested worse late outcomes following TAVR. TAVR was consistently associated with fewer postoperative complications, whereas durability and re-intervention findings varied across studies. Overall, these results suggest that while TAVR offers meaningful advantages, treatment decisions should be individualized to balance a patient's comorbidities with long-term procedural outcomes.

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