{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:07:51Z","timestamp":1781114871813,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We wished to undertake a reconstructed individual patient data meta\u2010analysis of randomized clinical trials comparing transcatheter aortic valve replacement (TAVR) and surgery for patients with severe symptomatic aortic stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>TAVR and surgery are both well\u2010established methods for treating patients with symptomatic severe aortic stenosis who are at low, intermediate, and high risk for surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were identified by searches of Medline, Embase, CENTRAL and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> for all randomized clinical trials, which compared TAVR and surgery that had published at least 1 year of follow\u2010up. Individual patient data were reconstructed from Kaplan\u2013Meier curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7,770 patients from seven randomized clinical trials were included in this meta\u2010analysis. At 1 year, TAVR was associated with a lower risk of death from any cause (hazard ratio [HR], 0.85, 95% confidence interval [CI], 0.73\u20130.98; <jats:italic>p<\/jats:italic> = .03), disabling stroke (HR, 0.71; 95% CI, 0.54\u20130.93; <jats:italic>p<\/jats:italic> = .01) and the composite end point of death or disabling stroke (HR, 0.79; 95% CI, 0.67\u20130.92; <jats:italic>p<\/jats:italic> = .002). Significant interactions were found for access suitability, with TAVR associated with a lower risk of these end points in patients suitable for transfemoral access. TAVR was associated with a lower risk of periprocedural events, whereas the risk of late events was similar between TAVR and surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At 1 year, TAVR was associated with a lower risk of death, disabling stroke and the composite end point, when compared with surgery. These associations were strongest within the subgroup of patients in whom transfemoral access was feasible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28504","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T04:12:08Z","timestamp":1569903128000},"page":"158-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Transcatheter aortic valve replacement versus surgery for symptomatic severe aortic stenosis: A reconstructed individual patient data meta\u2010analysis"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3191-5361","authenticated-orcid":false,"given":"Cameron","family":"Dowling","sequence":"first","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University of London and St. George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreenivasa 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