Both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are associated with a significant improvement in survival among patients with low-gradient severe aortic stenosis (LGAS), according to a new meta-analysis published in JACC: Cardiovascular Interventions.
The study’s authors tracked data from 32 different studies completed through October 2020. The meta-analysis included more than 6,500 patients who underwent aortic valve replacement (AVR) for low-flow, low-gradient (LF-LG), paradoxical LF-LG and normal-flow or low-gradient (NF-LG) aortic stenosis. The median follow-up time was 24.2 months.
Overall, AVR—either the transcatheter or surgical approach—was associated with a significant decrease in all-cause mortality when compared to conservative patient management.
Also, the authors added, there was “no significant difference” in all-cause mortality between patients who underwent TAVR and SAVR. This suggests both approaches to AVR are safe and effective for treating patients with LGAS.
“Our meta-analysis revealed AVR to decrease all-cause mortality compared to conservative management,” wrote lead author Hiroki Ueyama, MD, of the Icahn School of Medicine at Mount Sinai in New York City, and colleagues. “This outcome demonstrated high heterogeneity, likely reflecting the varied underlying pathophysiology encompassed within this sub-class of LGAS. Although our result may support AVR as a reasonable option for NF-LG aortic stenosis patients, a further prospective study is warranted to come to conclusion.”
The full analysis is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.