Transcatheter aortic valve replacement (TAVR) has become the choice for the treatment of severe aortic stenosis(AS) patients at high surgical risk in clinical practice. This meta-analysis aimed to further investigate the effect of the relative hemodynamics and postoperative LV remodeling by TAVR and surgical aortic valve replacement(SAVR).
Relevant studies were identified via systematic searches of PubMed, Google Scholar, and the Cochrane database. Relevant data were pooled as weighted mean difference (WMD) or odds risk(OR), with their 95% confidence intervals (CI). A random-effect model or fixed effect model was utilized according to the results of the heterogeneity test.
The results indicated that peak aortic pressure gradient (WMD=-3.86, 95%CI(-6.63,-1.09), P = 0.006) and left ventricular ejection fraction (LVEF%) (WMD=-0.66, 95%CI(-1.31,-0.22), P = 0.045) were lower in the TAVR group compared with the SAVR group, but there was no significant difference between TAVR group and SAVR group in effective orifice area(EOA)(WMD = 0.05, 95%CI(-0.19,0.28), P = 0.697), left ventricular mass(LVM)(WMD = 5.24, 95%CI(-10.33, 20.80), P = 0.509). Compared with SAVR group, the incidence of prosthesis-patient mismatch(PPM) was significantly lower in the TAVR group(OR = 0.37, 95% CI(0.23, 0.61), P < 0.0001).
For patients with severe AS, TAVR could have better performance on the hemodynamics than after SAVR in terms of peak aortic pressure gradient, LVEF%, and the incidence of PPM, TAVR was comparable to SAVR at LV remodeling.