{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T20:25:58Z","timestamp":1776371158750,"version":"3.51.2"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T00:00:00Z","timestamp":1600041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) is regarded as the most superior alternative treatment approach for patients with aortic stenosis (AS) who are associated with high surgical risk, whereas the effectiveness of TAVR vs surgical aortic valve replacement (SAVR) in low to intermediate surgical risk patients remained inconclusive. This study aimed to determine the best treatment strategies for AS with low to intermediate surgical risk based on published randomized controlled trials (RCTs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis and Methods<\/jats:title><jats:p>RCTs that compared TAVR vs SAVR in AS patients with low to intermediate surgical risk were identified by PubMed, EmBase, and the Cochrane library from inception till April 2019. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated for the data collected using random\u2010effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven RCTs with a total of 6929 AS patients were enrolled. We noted that TAVR significantly increased the risk of transient ischemic attack (TIA) (RR: 1.43; 95%CI: 1.04\u20101.96; <jats:italic>P<\/jats:italic> = .029), and permanent pacemaker implantation (RR: 3.00; 95%CI: 1.70\u20105.30; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). However, TAVR was associated with lower risk of post\u2010procedural bleeding (RR: 0.57; 95%CI: 0.33\u20100.98; <jats:italic>P<\/jats:italic> = .042), new\u2010onset or worsening of atrial fibrillation (RR: 0.32; 95%CI: 0.23\u20100.45; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), acute kidney injury (RR: 0.40; 95%CI: 0.25\u20100.63; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and cardiogenic shock (RR: 0.34; 95%CI: 0.19\u20100.59; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The risk of aortic\u2010valve reintervention at 1\u2010 (RR: 2.63; 95%CI: 1.34\u20105.15; <jats:italic>P<\/jats:italic> = .005), and 2\u2009years (RR: 3.19; 95%CI: 1.63\u20106.24; <jats:italic>P<\/jats:italic> = .001) in low to intermediate surgical risk patients who received TAVR was significantly increased than those who received SAVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings indicated that low to intermediate surgical risk patients who received TAVR had low risk of complications, whereas the risk of TIA, permanent pacemaker implantation, and aortic\u2010valve reintervention was increased.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23454","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T12:36:01Z","timestamp":1600950961000},"page":"1414-1422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Transcatheter vs surgical aortic valve replacement in low to intermediate surgical risk aortic stenosis patients: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"43","author":[{"given":"Dengshen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery The Affiliated Hospital of Zunyi Medical University  Zunyi Guizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery The Affiliated Hospital of Zunyi Medical University  Zunyi Guizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8288-5911","authenticated-orcid":false,"given":"Daxing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery The Affiliated Hospital of Zunyi Medical University  Zunyi Guizhou 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