Evidence map›Paper›PMID 41714983›Full record

SynthesisBMC cardiovascular disorders2026

Transcatheter versus surgical aortic valve replacement in low-risk patients with severe aortic stenosis: a systematic review and meta-analysis.

Ziad A Fadl, Moaz Yasser Darwish, Walaa M Moawad, Nada Osama Aboelmagd, Ganna Abdelrhman Fadl, Mostafa Wanees Ahmed El Husseny, Nada K Abdelsattar, Taha Abd-ElSalam Ashraf Taha

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

8 authors.

Ziad A FadlFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Moaz Yasser DarwishFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Walaa M MoawadFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Nada Osama AboelmagdFaculty of Medicine, Qena University, Qena, Egypt.
Ganna Abdelrhman FadlFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Mostafa Wanees Ahmed El HussenyDepartment of Adult Cardiology, Aswan Heart Centre, Aswan, Egypt.
Nada K Abdelsattar *Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Taha Abd-ElSalam Ashraf Taha *Faculty of Medicine, Fayoum University, Fayoum, Egypt. ta1295@fayoum.edu.eg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal revascularization strategy for low-risk patients with severe aortic stenosis (AS), transcatheter (TAVI) versus surgical aortic valve replacement (SAVR), remains a subject of ongoing debate, particularly regarding long-term outcomes. We aimed to synthesize the evidence on the comparative safety and efficacy of TAVI and SAVR in this population.

methodsWe conducted a systematic review and meta-analysis, searching PubMed, Scopus, Web of Science, and Cochrane Library until March 2025. We included randomized controlled trials (RCTs) and comparative observational studies enrolling low-risk patients with severe AS. Primary outcomes were all-cause mortality and stroke, analyzed at different time points. Data were pooled using random-effects models, with subgroup analyses based on study design.

resultsThirty studies, including 48,210 patients, were included. TAVI was associated with a significantly lower risk of 30-day mortality (Relative Risk [RR] 0.66, 95% CI 0.50–0.76) and 30-day stroke (RR 0.70, 95% CI 0.53–0.92). However, in the overall analysis, SAVR was favored for one-year mortality (RR 1.11, 95% CI 1.01–1.21), with equipoise in long-term follow-up. TAVI significantly reduced the risks of 30-day major bleeding (RR 0.38, 95% CI 0.21–0.70) and atrial fibrillation (RR 0.41, 95% CI 0.22–0.76). Conversely, TAVI was associated with a persistently higher risk of permanent pacemaker implantation (RR 2.44 at 30 days, 95% CI 1.76–3.40) and paravalvular leakage (RR > 5-fold at both 30 days and 1 year).

conclusionIn low-risk patients with severe AS, TAVI offers clear early procedural safety advantages, particularly regarding stroke, bleeding, and atrial fibrillation. While the overall analysis suggested a 30-day mortality benefit for TAVI and a 1-year mortality benefit for SAVR, these findings were driven principally by observational data and were not statistically significant in the subgroup of randomized controlled trials. These procedural benefits are counterbalanced by a persistently higher risk of permanent pacemaker implantation and paravalvular leakage with TAVI. The choice of intervention requires a nuanced, individualized approach through shared decision-making, weighing early recovery benefits against device-related risks and the divergence between trial and registry outcomes.

Indexed as

Aortic ValveAortic Valve StenosisHeart Valve Prosthesis ImplantationTranscatheter Aortic Valve ReplacementAgedAged, 80 and overFemaleHumansMaleRecovery of FunctionRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeAortic stenosisLow riskSAVRTAVR

Identifiers

PMID41714983
PMCPMC12930610

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.