{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T16:09:23Z","timestamp":1777738163750,"version":"3.51.4"},"reference-count":58,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"International Society for Minimally Invasive Cardiothoracic Surgery"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>There is an increasing amount of evidence supporting use of transcatheter aortic valve replacement (TAVR) for treatment of aortic stenosis in patients at low or intermediate risk for surgical aortic valve replacement (SAVR). TAVR is now approved for use in all patient cohorts. Despite this, there remains debate about the relative efficacy of TAVR compared with SAVR in lower-risk cohorts and various subgroups of patients. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and propensity-matched trials to guide a consensus among expert cardiologists and surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Studies comparing TAVR and SAVR in low- and intermediate-risk patients were identified by a thorough search of the major databases. Mortality, stroke, and other perioperative outcomes were assessed at 30 days and 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Early mortality was lower in TAVR compared to SAVR in RCTs, but not propensity-matched studies in low-risk cohorts (0.66% vs 1.5%; odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20 to 0.98, I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). No difference in mortality between TAVR and SAVR was identified in intermediate-risk patients at early or later time points. Incidence of perioperative stroke in 3 low-risk RCTs was significantly lower in TAVR (0.4%) than SAVR (1.4%; OR = 0.33, 95% CI 0.13 to 0.81, I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). There was no difference in stroke for intermediate-risk patients between TAVR and SAVR. The expert panel of cardiologists and cardiac surgeons provided recommendations for TAVR and SAVR in various clinical scenarios.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In RCTs comparing TAVR and SAVR in low-risk patients, early mortality and stroke were lower in TAVR, but did not differ at 1 year. There was no difference in mortality and stroke in intermediate-risk patients. The Multidisciplinary Heart Team must consider individual patient characteristics and preferences when recommending TAVR or SAVR. The decision must consider the long-term management of each patient\u2019s aortic valve disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1556984520978316","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T21:32:21Z","timestamp":1611610341000},"page":"3-16","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["The International Society for Minimally Invasive Cardiothoracic Surgery Expert Consensus Statement on Transcatheter and Surgical Aortic Valve Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of Randomized and Propensity-Matched Studies"],"prefix":"10.1177","volume":"16","author":[{"given":"Vinod H.","family":"Thourani","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Marcus Heart and Vascular Center, Piedmont Heart and Vascular Institute, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. James","family":"Edelman","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Fiona Stanley Hospital, University of Western Australia, Perth, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sari D.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom C.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Adult Cardiothoracic Surgery, University of California, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Carroll","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Colorado, Denver, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Baylor Health Care System, Heart Hospital Baylor Plano, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert H. L.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susheel","family":"Kodali","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher U.","family":"Meduri","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Marcus Heart and Vascular Center, Piedmont Heart Institute, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Forcillo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CHUM), Montr\u00e9al, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis D.","family":"Ferdinand","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine & UPMC Hamot Heart and Vascular Institute, University of Pittsburgh Medical Center, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Fontana","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Los Robles Hospital and Medical Center, Thousand Oaks, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Suwalski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bob","family":"Kiaii","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, UC Davis Medical Center, Sacramento, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husam","family":"Balkhy","sequence":"additional","affiliation":[{"name":"Section of Cardiac Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joerg","family":"Kempfert","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, German Heart Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anson","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The University of British Columbia, St. Paul\u2019s Hospital, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Borger","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Leipzig Heart Centre, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Reardon","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin B.","family":"Leon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Popma","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niv","family":"Ad","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"Cardiovascular Surgery, Adventist White Oak Medical Center, Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"bibr1-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"bibr2-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400590"},{"key":"bibr3-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60308-7"},{"key":"bibr4-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.2146"},{"key":"bibr5-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"bibr6-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700456"},{"key":"bibr7-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.083"},{"key":"bibr8-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"bibr9-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"bibr10-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.06.050"},{"key":"bibr11-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.09.005"},{"key":"bibr12-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.07.002"},{"key":"bibr13-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.01.136"},{"key":"bibr14-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.013"},{"key":"bibr15-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.014"},{"key":"bibr16-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.12.022"},{"key":"bibr17-1556984520978316","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30073-3"},{"key":"bibr18-1556984520978316","first-page":"541","volume":"23","author":"Castrodeza 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