A Meta-Analyis On Efficacy And Safety Of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement For Severe Aortic Stenosis

Objective The efficacy and safety of TAVI versus SAVR in patients with severe aortic stenosis was analyzed in this Meta-analysis.Method SAVR is the stand treatment for severe aortic stenosis, we try to confirm that TAVI is superior or not inferior to SAVR. A comprehensive literature search of foreign major electronic databases of evaluating the effects of TAVI versus SAVR in patients with severe aortic stenosis. After filtrate the clinical research, we got all-cause mortality at 30 days, long-term all-cause mortality, cardiovascular mortality,MI and stroke. Finally we used the meta-analysis of the data gathering from the studies by the software of STATA 11.Result Seventeen retrospective cohort studies and three randomized trial (n=5805) from 2009 to 2014 comparing TAVI (n=2844) and SAVR (n=2961) were included. Data of meta-analysis shows:There was no significant difference found in all-cause mortality at 30 days (RR 1.09,95%CI 0.89 to 1.33,p=0.426), and at an average of 18.7 months (RR 1.05,95%CI 0.97 to 1.13,p=0.209) There was no significant difference in cardiovascular mortality of 21.8 months (RR 0.92,95%CI 0.69 to 1.23,p=0.582). And there was no significant difference in the incidence of myocardial infarction of 15.1 months (RR 1.13, 95%CI 0.51 to 2.49,p=0.763) and stroke of 12.5 months (RR 1.11,95%CI 0.76 to 1.63,p=0.581)Conclusion TAVI is not inferior to SAVR in all-cause mortality at early or long-term follow-up. TAVI has similar cardiovascular mortality as well as major adverse cardiovascular and cerebrovascular events.In the treatment of severe aortic stenosis,TAVI is a safe alternative to SAVR in high-risk patients or patients have contraindications.