{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:07Z","timestamp":1787018107396,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,11,7]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">We performed a meta\u2010analysis of reconstructed time\u2010to\u2010event data from randomized controlled trials (RCTs) and propensity\u2010score matched (PSM) studies comparing transcatheter versus surgical aortic valve replacement (TAVR versus SAVR) to evaluate midterm outcomes in patients considered low risk for SAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Study\u2010level meta\u2010analysis of reconstructed time\u2010to\u2010event data from Kaplan\u2013Meier curves of RCTs and PSM studies published by December 31, 2022 was conducted. Eight studies (3 RCTs, 5 PSM studies) met our eligibility criteria and included 5444 patients; 2639 patients underwent TAVR, and 2805 patients underwent SAVR. TAVR showed a higher risk of all\u2010cause mortality at 8\u2009years of follow\u2010up (hazard ratio [HR] 1.22, [95% CI, 1.03\u20131.43],\n                      <jats:italic>P<\/jats:italic>\n                      =0.018). Up to 2\u2009years of follow\u2010up, TAVR was not inferior to SAVR (HR, 1.08 [95% CI, 0.89\u20131.31],\n                      <jats:italic>P<\/jats:italic>\n                      =0.448); however, we observed a statistically significant difference after 2\u2009years with higher mortality with TAVR (HR, 1.51 [95% CI, 1.14\u20132.00];\n                      <jats:italic>P<\/jats:italic>\n                      =0.004). This difference was driven by PSM studies; our sensitivity analysis showed a statistically significant difference between TAVR and SAVR when we included only PSM studies (HR, 1.41 [95% CI, 1.16\u20131.72],\n                      <jats:italic>P<\/jats:italic>\n                      =0.001) but no statistically significant difference when we included only RCTs (HR, 0.89 [95% CI, 0.69\u20131.16],\n                      <jats:italic>P<\/jats:italic>\n                      =0.398).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In comparison with TAVR, SAVR appeared to be associated with improved survival beyond 2\u2009years in low\u2010risk patients. However, the survival benefit of SAVR was observed only in PSM studies and not in RCTs. The addition of data from ongoing RCTs as well as longer follow\u2010up in previous RCTs will help to confirm if there is a difference in mid\u2010 and long\u2010term survival between TAVR versus SAVR in the low\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.030012","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T05:27:51Z","timestamp":1699248471000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Midterm Survival of Low\u2010Risk Patients Treated With Transcatheter Versus Surgical Aortic Valve Replacement: Meta\u2010Analysis of Reconstructed Time\u2010to\u2010Event Data"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh PA USA"},{"name":"UPMC Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8421-0686","authenticated-orcid":false,"given":"Xander","family":"Jacquemyn","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-6385","authenticated-orcid":false,"given":"Derek","family":"Serna\u2010Gallegos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh PA USA"},{"name":"UPMC Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2183-6072","authenticated-orcid":false,"given":"Danny","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh PA USA"},{"name":"UPMC Heart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8924-740X","authenticated-orcid":false,"given":"Marie\u2010Annick","family":"Clavel","sequence":"additional","affiliation":[{"name":"Centre de Recherche de l\u2019Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Qu\u00e9bec City Qu\u00e9bec Canada"},{"name":"Department of Medicine, Faculty of Medicine Universit\u00e9 Laval Qu\u00e9bec City Qu\u00e9bec 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