Morbidity and Mortality in Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement
- Arlin D. ,
- Malyshev G. and
- Nakamura M.
- Arlin D. ,
- Malyshev G. and
- Nakamura M.
2019
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Description
Background: This evidence-based medicine literature review compares outcomes of morbidity and mortality between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Although originally approved for patients who were prohibitively high risk for surgery, TAVR has been studied in patients who are intermediate or lower risk for surgery. Objective: To determine whether TAVR is equal to, inferior to, or superior to SAVR in terms of mortality and morbidity amongst different patient groups. Methods: A search of three different databases was conducted with three similar search phrases. Three researchers independently reviewed titles and abstracts against articles for relevance using inclusion and exclusion criteria. Articles that met this criterion had a full text review and were further limited to the highest level of evidence and best application to the research question. Results: The three selected studies were all meta-analysis and systematic reviews. TAVR and SAVR are similar in terms of morbidity and mortality in most patient groups except for some specific circumstances. Two out of three studies favored TAVR in stroke outcomes, major bleeding, new onset atrial fibrillation, acute kidney injury, and hospital stay. SAVR was favored for all three studies for outcomes of permanent pacemaker implantation and paravalvular leaks. Overall mortality, myocardial infarction, sex category, and endocarditis did not show preference for one method or did not have data on the outcome. Conclusion: The analyzed studies support noninferiority TAVR when compared to SAVR for outcomes concerning overall morbidity, mortality, stroke, major bleeding, and acute kidney injury. TAVR has been supported as an an equally viable option for aortic valve replacements which is relevant for clinicians and their patients who desire less invasive procedures.
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Record Data:
- Program:
- Physician Assistant Studies
- Location:
- Knoxville
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