Comparative effectiveness of transcatheter vs surgical aortic valve replacement: A systematic review and meta-analysis

Table 1 Baseline characteristics of included studies

Trial name	Ref.	Year	Location	Total sample	Sample size (TAVR/SAVR)		Mean age (years)	Follow-up (years)
PARTNER 1	Smith et al[26]	2011	United States, Canada, and Germany	699	348	351	84 ± 6.6	1
	Kodali et al[27]	2012	United States, Canada, and Germany	699	348	351	84 ± 6.6	2
	Mack et al[28]	2015	United States, Canada, and Germany	699	348	351	84 ± 6.6	5
Medtronic Core Valve® United States Pivotal Trial	Adams et al[7]	2014	United states	747	390	357	83.2 ± 6.7	1
	Reardon et al[8]	2015		750	391	359	83.2 ± 6.7	2
	Deeb et al[9]	2016		750	391	359	83.2 ± 6.7	3
	Arnold et al[10]	2021		713	377	336	83.2 ± 6.7	5
NOTION	Thyregod et al[18]	2015	Northern Europe	280	145	135	79.1 ± 4.8	1
	Søndergaard et al[19]	2016		280	142	134	79.1 ± 4.8	2
	Thyregod et al[20]	2019		280	145	135	79.1 ± 4.8	5
PARTNER 2	Leon et al[11]	2016	United States, Canada	2032	1011	1021	81.5 ± 6.7	2
	Makkar et al[12]	2020		2032	1011	1021	81.5 ± 6.7	5
Medtronic SURTAVI trial	Reardon et al[14]	2017	United States	1660	863	794	79.8 ± 6.2	2
PARTNER 3	Mack et al[15]	2019	United States	950	496	454	73	1
	Leon et al[16]	2021		1,000	503	497	73	2
	Mack et al[17]	2023		1000	503	497	73	5
Evolut low-risk	Popma et al[23]	2019	Australia, Canada, France, Japan, the Netherlands, New Zealand, and the United States	1403	725	678	73.9 ± 5.85	1 and 2
	Forrest et al[24]	2022	Australia, Canada, France, the Netherlands, New Zealand, Japan, and the United States	1414	730	684	73.9 ± 5.85	2
	Forrest et al[25]	2023	Australia, Canada, France, the Netherlands, New Zealand, Japan, and the United States	1414	730	684	73.9 ± 5.85	3
UK TAVI	Toff et al[21]	2022	United Kingdom	931	458	455	81 ± 3.7	1
The VIVA trial	Rodés-Cabau et al[13]	2024	United States	156	79	77	75.5 ± 5.1	1-5
DEDICATE-DZHK6	Blankenberg et al[22]	2024	Germany	1414	701	713	74 ± 4	1

TAVR: Transcatheter aortic valve replacement; SAVR: Surgical aortic valve replacement.

Table 2 Summary of outcomes for transcatheter aortic valve replacement vs surgical aortic valve replacement

Outcome	Follow up period	Events/totals		Risk ratio (95%CI)	P value
		TAVR	SAVR
All-cause mortality	1 year	295/3834	370/3613	0.74 (0.61-0.91)	0.004
	2 years	637/3421	631/3285	0.99 (0.89-1.10)	0.87
	3 years	170/1121	185/1043	0.85 (0.72-1.02)	0.08
	5 years	1124/2377	951/2297	1.13 (1.01-1.26)	0.03
Stroke	1 year	253/4845	274/4634	0.89 (0.67-1.19)	0.44
	2 years	259/3566	266/3420	0.93 (0.75-1.16)	0.54
	3 years	98/1121	101/1043	0.90 (0.75-1.16)	0.67
	5 years	109/1380	115/1299	0.89 (0.69-1.14)	0.43
Disabling stroke	1 year	127/3814	157/3688	0.77 (0.53-1.13)	0.05
	2 years	91/2692	115/2575	0.72 (0.48-1.08)	0.11
	5 years	98/1507	86/1475	1.11 (0.84-1.47)	0.45
Cardiac mortality	1 year	225/3914	248/3804	0.87 (0.70-1.10)	0.24
	2 years	320/3566	331/3420	0.94 (0.81-1.08)	0.38
	3 years	112/1121	121/1043	0.86 (0.68-1.09)	0.21
	5 years	448/2000	398/1961	1.13 (1.01-1.27)	0.04
Myocardial infarction	1 year	74/4346	81/4156	0.88 (0.64-1.21)	0.42
	2 years	89/3566	87/3420	1.00 (0.75-1.35)	0.98
	3 years	33/1121	23/1043	1.33 (0.79-2.26)	0.28
	5 years	110/2000	99/1961	0.87 (0.48-1.59)	0.04
New permanent pacemaker insertion	1 year	483/3482	245/3360	2.03 (1.41-2.94)	0.0002
	2 years	681/3566	274/3420	2.45 (1.54-3.90)	0.0002
	3 years	264/1121	104/1043
				2.33 (1.83-2.98)	< 0.00001
	5 years	287/2000	189/1961	1.72 (1.03-2.88)	0.04
Acute kidney injury	1 year	98/3027	165/2929	0.54 (0.34-0.86)	0.009
	2 years	95/2614	470/2527	0.35 (0.09-1.39)	< 0.00001
	5 years	24/348	24/351	1.01 (0.58-1.74)	0.98
Hospitalization	1 year	297/2492	293/2437	0.98 (0.76-1.27)	0.91
	2 years	424/3030	356/2926	1.14 (0.95-1.37)	0.15
	5 years	454/1855	364/1825	1.16 (0.87-1.55)	0.31
Aortic valve re-intervention	1 year	53/3856	17/3694	2.68 (1.54-4.64)	0.0005
	2 years	53/3073	18/2934	2.58 (1.40-4.73)	0.002
	3 years	16/1121	7/1043	2.50 (0.33-18.84)	0.37
	5 years	36/1652	19/1610	1.89 (0.66-5.36)	0.23
New atrial fibrillation	1 year	299/3444	686/3298	0.53 (0.31-0.89)	0.02
	2 years	332/2488	846/2385	0.39 (0.30-0.49)	< 0.00001
	5 years	196/1507	446/1475	0.40 (0.27-0.60)	< 0.00001
Paravalvular leak	2 years	23/1431	6/1397	3.62 (1.46-8.95)	0.005
Major bleeding	1 year	406/3485	945/3384	0.43 (0.30-0.62)	< 0.00001
	2 years	330/2410	385/2264	0.74 (0.52-1.04)	0.08
Major vascular complication	1 year	296/3485	107/3384	3.07 (1.75-5.40)	< 0.0001
	2 years	232/3344	107/3211	2.39 (1.39-4.11)	0.002

TAVR: Transcatheter aortic valve replacement; SAVR: Surgical aortic valve replacement.