Evidence map›Paper›PMID 40328422›Full record

Observational studyThe Journal of thoracic and cardiovascular surgery2025

Outcomes of surgical versus transcatheter aortic valve replacement in patients with low-flow, low-gradient aortic stenosis.

James A Brown, Eishan Ashwat, Nav Warraich, Nidhi Iyanna, Derek Serna-Gallegos, Dustin Kliner, Catalin Toma, David West, Amber Makani, Irsa Hasan and 5 more

Abstract readObservational StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of thoracic and cardiovascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. [Numerical simulation study on the influence of free edge configuration on the performance of polymeric heart valves].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2026
    Article
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

15 authors.

James A BrownDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Eishan AshwatDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Nav WarraichDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Nidhi IyannaDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Derek Serna-GallegosDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Dustin KlinerDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Catalin TomaDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
David WestDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Amber MakaniDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Irsa HasanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Takuya OgamiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Danial AhmadDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Floyd ThomaDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Yisi WangDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
Ibrahim SultanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa. Electronic address: sultani@upmc.edu.

Funding

Cardiothoracic Surgery Research Training ProgramT32HL160526 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JAMES D LUKETICH, Julie A Phillippi · 2022 to 2026
$1.5M
NHLBI NIH HHS T32 HL160526
6 · The paper itself

Abstract

objectiveThis study sought to determine the impact of surgical versus transcatheter aortic valve replacement in patients with low-flow, low-gradient aortic stenosis.

methodsThis was an observational study of consecutive aortic valve replacements for severe aortic stenosis from 2010 to 2023. Patients with low-flow, low-gradient aortic stenosis (aortic valve mean gradient <40 mm Hg and a stroke volume index <35 mL/m

resultsA total of 575 patients underwent isolated, first-time aortic valve replacement for low-flow, low-gradient aortic stenosis, of whom 248 (43%) were low operative risk (Society of Thoracic Surgeons Predicted Risk of Mortality <4%). A total of 131 patients (52.8%) underwent surgical aortic valve replacement, and 117 patients (47.2%) underwent transcatheter aortic valve replacement. Those undergoing transcatheter aortic valve replacement were older than those undergoing surgical aortic valve replacement: 79.0 [76.0-84.0] years versus 66.0 [59.0-73.0] years (P < .001). The incidence of 30-day mortality, stroke, and pacemaker was not different across each group, but the incidence of paravalvular leak was higher in the transcatheter aortic valve replacement group. At 1-year follow-up, aortic valve mean gradient (9.0 [7.0-12.0] mm Hg) and ejection fraction (55.0% [40.0-60.0]) were no different across each group. On multivariable analysis, transcatheter aortic valve replacement was not associated with an increased hazard of death compared with surgical aortic valve replacement (hazard ratio, 1.38, 95% CI, 0.72-2.66, P = .34) or an increased hazard of heart failure readmission (hazard ratio, 1.70, 95% CI, 0.88-3.30, P = .11) compared with surgical aortic valve replacement.

conclusionsFor patients with low-flow, low-gradient aortic stenosis, surgical and transcatheter approaches to aortic valve replacement may be equally as advantageous with respect to long-term outcomes.

Indexed as

Aortic ValveAortic Valve StenosisHeart Valve Prosthesis ImplantationTranscatheter Aortic Valve ReplacementAgedAged, 80 and overFemaleHemodynamicsHumansMalePostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexStroke Volumeaortic stenosissurgical aortic valve replacementtranscatheter aortic valve replacement

Identifiers

PMID40328422
PMCPMC12283094

What OpenQuestion holds

Textmetadata
LicenceTDM
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.