A recent systematic review and meta-analysis indicates that transcatheter aortic valve implantation (TAVI) results in higher all-cause mortality and an increased risk of stroke compared to surgical aortic valve replacement (SAVR) over a five-year period. The study examined patients with severe aortic stenosis at low- to intermediate-surgical risk.
Historically, TAVI was reserved for patients unable to undergo surgery or as an alternative for high-risk individuals. However, its use has expanded to lower-risk groups following recent trials. Concerns remain about TAVI's long-term effectiveness, especially as it's increasingly used in younger patients with longer life expectancies.
The analysis, encompassing six randomized controlled trials with over 7,200 patients, found a 5-year all-cause mortality rate of 29.7% for TAVI versus 27.6% for SAVR. The data shows a high probability that SAVR is superior for overall survival and offers a reduced likelihood of stroke at the five-year mark.
While the findings were consistent across risk groups, the analysis's generalizability may be limited by heterogeneity in valve technology and patient characteristics across the included trials. Researchers stressed that TAVI remains a vital option for high-surgical-risk patients but cautioned against its broader adoption in younger, lower-risk populations.