Are the Rates of Stroke Similar in TAVR and Surgery?

Courtesy of Dr. Carlos Fava.

Stroke is one of the most undesirable complications we can face and, regarding transcatheter aortic valve replacement (TAVR), major studies presented have rates of stroke of about 4%. In others, rates have been slightly higher.

This meta-analysis included 5 randomized studies between 2011 and 2017: PARTNER, CoreVALVE, NOTION, PARTNER 2, and SURTAVI. Among included patients, 2755 underwent TAVR and 2659 underwent surgical aortic valve replacement. The rates of stroke were analyzed in both groups.

 

At 30 days, no differences were observed in the risk for stroke (relative risk [RR]: 0.85; 95% confidence interval [CI]: 0.59-1.22), major stroke (RR: 0.89; 95% CI: 0.53-1.51), or any kind of cerebrovascular event (RR: 0.94; 95% CI: 0.75-1.17) between strategies.


Read also: Angina Is as Subjective as Any Other Pain.


After a 1-year follow-up, no differences were observed either regarding the risk for stroke (RR: 0.92; 95% CI: 0.69-1.22), major stroke (RR: 0.92; 95% CI: 0.62-1.37), and any kind of cerebrovascular event (RR: 1.03; 95% CI: 0.79-1.33).

 

There was also an analysis between 30 days and 1 year, which showed no differences between TAVR and surgery.

 

Conclusion

This meta-analysis comparing TAVR and surgical aortic valve replacement showed comparable risk for stroke or any cerebrovascular event.

 

Editorial Comment

This meta-analysis shows similar risk for both strategies, but we must take into account that the studies analyzed are the first that began to show the benefit of TAVR with first-generation valves.

 

Second-generation valves and greater operator experience have proved to result in a lower risk of cerebrovascular events. Furthermore, there are increasingly more studies including cerebral protection systems in which the number of events is surely decreasing, thus ensuring higher TAVR effectiveness.

 

Courtesy of Dr. Carlos Fava.

 

Original title: Comparative Analysis of Cerebrovascular Events in Transcatheter and Surgical Aortic Valve Replacement: A Systematic Review and Meta-Analysis of Randomised Trials.

Reference: Divyanshu Mohananey, EuroIntervention 2018;14:69-77.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...

TAVR in Young Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has established itself as an effective strategy for the treatment of severe aortic stenosis across different risk groups. While previous...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...