Evidence map›Paper›PMID 41859815›Full record

SynthesisStroke2026

Stroke Risk After Bioprosthetic Aortic Valve Replacement in Aortic Stenosis: Systematic Review and Meta-Analysis.

Tarek Bou Dargham, Sara Hassani, Brian Mac Grory, Melissa A Daubert, Dylan Ryan, Tracy Truong, Mohamad B Moumneh, Samantha J Kaplan, Wuwei Feng, Nada El Husseini

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Stroke, 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. 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

10 authors.

Tarek Bou DarghamDepartment of Neurosurgery (T.B.D.), Duke University School of Medicine, Durham, NC.ORCID 0000-0002-8126-9559
Sara HassaniDepartment of Neurology, Feinberg School of Medicine Northwestern University, Chicago IL (S.H.).ORCID 0000-0002-0406-4146
Brian Mac GroryDepartment of Neurology (B.M.G., D.R., W.F., N.E.H.), Duke University School of Medicine, Durham, NC.ORCID 0000-0003-3914-8419
Melissa A DaubertDivision of Cardiology, Department of Medicine (M.A.D.), Duke University School of Medicine, Durham, NC.ORCID 0000-0002-8485-565X
Dylan RyanDepartment of Neurology (B.M.G., D.R., W.F., N.E.H.), Duke University School of Medicine, Durham, NC.ORCID 0000-0001-7254-0020
Tracy TruongDepartment of Biostatistics & Bioinformatics (T.T.), Duke University School of Medicine, Durham, NC.ORCID 0000-0001-5923-4037
Mohamad B MoumnehInova Center of Outcomes Research, Inova Heart and Vascular, Fairfax, VA (M.B.M.).
Samantha J KaplanMedical Center Library & Archives (S.J.K.), Duke University School of Medicine, Durham, NC.ORCID 0000-0001-5340-1754
Wuwei FengDepartment of Neurology (B.M.G., D.R., W.F., N.E.H.), Duke University School of Medicine, Durham, NC.ORCID 0000-0001-6230-4905
Nada El HusseiniDepartment of Neurology (B.M.G., D.R., W.F., N.E.H.), Duke University School of Medicine, Durham, NC.ORCID 0000-0002-6096-1116

Funding

Support for QA/QC for Prior Approval ProcessUL1TR002553 · NCATS · DUKE UNIVERSITY · PI LI, JENNIFER S, MCNAMARA, JAMES O. · 2018 to 2023
$58.5M
NCATS NIH HHS UL1 TR002553
6 · The paper itself

Abstract

backgroundStroke is a possible complication after bioprosthetic aortic valve replacement (AVR) for severe aortic stenosis (AS), impacting morbidity and mortality. Accurate estimates of the proportion of individuals who experience stroke within and beyond the periprocedural period after transcatheter AVR (TAVR), surgical AVR, and valve-in-valve (ViV) replacement are essential for management and prognostication. The objective was to determine the proportion of adults aged >18 who experienced an ischemic stroke after bioprosthetic AVR for AS.

methodsA systematic search of MEDLINE, Embase, and Web of Science was conducted from database inception through March 2024. Studies reporting on stroke rates at least 90 days after bioprosthetic AVR for severe AS, including ViV procedures, and meeting predefined eligibility criteria were included. The pooled proportion of individuals experiencing a stroke was estimated for TAVR and ViV procedures, whereas comparative analyses between TAVR and surgical AVR were performed using mixed-effects models in studies directly comparing both procedures.

resultsTwenty-seven studies were included in the native AS treatment cohort, and 5 in the ViV subanalysis. In native AS, the pooled 30-day proportion of individuals who had a stroke after TAVR was 3.0% (95% CI, 2.5-3.9), with different studies reporting major and minor stroke proportions of 1.7% each. At 1 year, all stroke proportion was 5.0% (95% CI, 4.0-6.0), major stroke was 3.0%, and minor stroke was 2.0%. Comparative analysis demonstrated that TAVR was associated with significantly lower odds of all stroke at 30 days compared with surgical AVR (odds ratio, 0.73 [95% CI, 0.57-0.93]). No significant difference in the proportions of individuals who had a stroke was observed in TAVR versus surgical AVR at 1, 2, or 5 years. In the ViV cohort, the pooled 30-day and 1-year all stroke proportion after ViV was 2.0% (95% CI, 1.0-3.0) and 3.0% (95% CI, 2.0-6.0), respectively.

conclusionsThis meta-analysis provides updated estimates of stroke after bioprosthetic AVR for AS, capturing risk beyond the early periprocedural period. Future studies should investigate the causes of long-term stroke post-AVR, the effects of different antithrombotic therapies on the risk of stroke, as well as the potential impact of these procedures on short and long-term cognitive function.

Indexed as

Aortic ValveAortic Valve StenosisBioprosthesisHeart Valve ProsthesisHeart Valve Prosthesis ImplantationPostoperative ComplicationsStrokeHumansRisk FactorsTranscatheter Aortic Valve Replacementaortic valve stenosisheart valvesriskstroketranscatheter aortic valve replacement

Identifiers

PMID41859815
PMCPMC13245270

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.