Evidence map›Paper›PMID 35357666›Full record

ArticleCardiology and therapy2022

Patients with Atrial Fibrillation Benefit from SAVR with Surgical Ablation Compared to TAVR Alone.

William L Patrick, Zehang Chen, Jason J Han, Benjamin Smood, Akhil Rao, Fabliha Khurshan, Siddharth Yarlagadda, Amit Iyengar, John J Kelly, Joshua C Grimm and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiology and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Cerebrovascular Events in Aortic Stenosis: From Native Valve Disease to TAVR-Specific Risk and Prevention.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Review
  2. Review
  3. What Are SAVR Indications in the TAVI Era?Journal of clinical medicine · 2025
    Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

William L PatrickDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. william.patrick@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0001-6803-6817
Zehang ChenDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Jason J HanDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Benjamin SmoodDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Akhil Rao
Fabliha KhurshanDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Siddharth YarlagaddaDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Amit IyengarDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
John J KellyDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Joshua C GrimmDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Marisa CevascoDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Joseph E BavariaDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Nimesh D DesaiDivision of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
University of Pennsylvania · USPenn Center for AIDS Research · USWilliam Penn University · US

Funding

Training Program in Cardiovascular Biology and MedicineT32HL007843 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI THOMAS P. CAPPOLA, Sharlene M Day · 1996 to 2026
$11.0M
NHLBI NIH HHS T32 HL007843NIH HHS T32HL007843
6 · The paper itself

Abstract

introductionIn patients with preoperative atrial fibrillation (AF) undergoing aortic valve replacement, the addition of surgical ablation to surgical aortic valve replacement (SAVR-SA) is efficacious and a Class I guideline. We hypothesized that this subgroup may benefit from SAVR-SA compared to transcatheter aortic valve replacement (TAVR) alone.

methodsMedicare beneficiaries with persistent non-valvular AF who underwent SAVR-SA or TAVR alone between 2012 and 2018 were included. Patients with high-risk surgical comorbidities were excluded. Groups were matched using inverse probability weighting. The primary outcome was all-cause mortality. Secondary outcomes were stroke, transient ischemic attack, permanent pacemaker implantation, bleeding, rehospitalization for atrial arrhythmias, and rehospitalization for heart failure. Kaplan-Meier estimates and Cox proportional-hazards regression were used to compare outcomes. Outcomes were adjusted for variables with a standardized mean difference greater than 0.1.

resultsOf 439,492 patients who underwent aortic valve replacement, 2591 underwent SAVR-SA and 1494 underwent TAVR alone. Weighting resulted in adequately matched groups. Compared to TAVR alone, SAVR-SA was associated with a significant reduction in all-cause mortality (HR 0.65, 95% CI 0.53-0.79), permanent pacemaker implantation (HR 0.62, 95% CI 0.44-0.87), bleeding (HR 0.63, 95% CI 0.39-1.00), and rehospitalization for heart failure (HR 0.49 (0.36-0.65). There was no difference in the incidence of stroke (HR 1.07, 95% CI 0.74-1.54), transient ischemic attack (HR 1.05, 95% CI 0.75-1.47), or rehospitalization for atrial arrhythmia.

conclusionSelect patients with persistent non-valvular AF may benefit from SAVR-SA compared to TAVR alone.

Indexed as

AblationAtrial fibrillationSAVRSurgical ablationSurgical aortic valve replacementTAVRTranscatheter aortic valve replacement

Identifiers

PMID35357666
PMCPMC9135921
OpenAlexW4221051281

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.