{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T06:57:27Z","timestamp":1762066647062,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In recent years, trans-catheter aortic valve implantation (TAVI) has emerged as an excellent alternative to surgical aortic valve replacement (SAVR). Currently, there are several approved devices on the market, yet comparisons among them are scarce. We aimed to compare the various devices via a network meta-analysis. Methods: We performed a network meta-analysis including randomized controlled trials (RCTs) and propensity-matched studies that provide comparisons of either a single TAVI with SAVR or two different TAVI devices and report clinical outcomes. Results: We included 12 RCT and 13 propensity-matched studies comprising 42,105 patients, among whom 27,134 underwent TAVI using various valve systems (Sapien &amp; Sapien XT, Sapien 3, Corvalve, Evolut &amp; Evolut Pro, Acurate Neo, Portico). The mean follow-up time was 23.4 months. Sapien 3 was superior over SAVR in the reduction of all-cause mortality (OR = 0.53; 95%CrI 0.31\u20130.91), while no significant difference existed between other devices and SAVR. Aortic regurgitation was more frequent among TAVI devices compared to SAVR. There was no significant difference between the various THVs and SAVR in cardiovascular mortality, myocardial infarction, NYHA class III-IV, and endocarditis. Conclusions: Newer generation TAVI devices, especially Sapien 3 and Evolut R\/Pro are associated with improved outcomes compared to SAVR and other devices of the older generation.<\/jats:p>","DOI":"10.3390\/jcm11185299","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T20:50:27Z","timestamp":1662670227000},"page":"5299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients"],"prefix":"10.3390","volume":"11","author":[{"given":"Ala","family":"Dogosh","sequence":"first","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7792-0708","authenticated-orcid":false,"given":"Ahlam","family":"Adawi","sequence":"additional","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aref","family":"El Nasasra","sequence":"additional","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Cafri","sequence":"additional","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5010-1035","authenticated-orcid":false,"given":"Orit","family":"Barrett","sequence":"additional","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-6504","authenticated-orcid":false,"given":"Gal","family":"Tsaban","sequence":"additional","affiliation":[{"name":"Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-8019","authenticated-orcid":false,"given":"Rami","family":"Barashi","sequence":"additional","affiliation":[{"name":"Meir Medical Center, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7907-6002","authenticated-orcid":false,"given":"Edward","family":"Koifman","sequence":"additional","affiliation":[{"name":"Meir Medical Center, Tel Aviv University, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.jacc.2017.05.060","article-title":"Transcatheter Versus Surgical Aortic Valve Replacement: Propensity-Matched Comparison","volume":"70","author":"Brennan","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1002\/ccd.27708","article-title":"Propensity matched comparison of in-hospital outcomes of TAVR vs. SAVR in patients with previous history of CABG: Insights from the Nationwide inpatient sample","volume":"92","author":"Nalluri","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.amjmed.2016.10.005","article-title":"Aortic Stenosis: Pathophysiology, Diagnosis, and Therapy","volume":"130","author":"Joseph","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/S0140-6736(09)60211-7","article-title":"Aortic stenosis","volume":"373","author":"Carabello","year":"2009","journal-title":"Lancet"},{"key":"ref_5","first-page":"93","article-title":"Aortic Stenosis: Diagnosis and Treatment","volume":"78","author":"Grimard","year":"2016","journal-title":"Am. Fam. Phys."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e022437","DOI":"10.1136\/bmjopen-2018-022437","article-title":"Comparative survival and role of STS score in aortic paravalvular leak after SAVR or TAVR: A retrospective study from the USA","volume":"8","author":"Padang","year":"2018","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ijcard.2018.06.011","article-title":"Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study","volume":"270","author":"Barbanti","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients","volume":"380","author":"Mack","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients","volume":"380","author":"Popma","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1007\/s00392-017-1097-y","article-title":"In-hospital mortality in propensi-ty-score matched low-risk patients undergoing routine isolated surgical or transfemoral transcatheter aortic valve replacement in 2014 in Germany","volume":"106","author":"Frerker","year":"2017","journal-title":"Clin. Res. Cardiol."},{"key":"ref_11","unstructured":"Writing Committee Members, Otto, C.M., Nishimura, R.A., Bonow, R.O., Carabello, B.A., Erwin, J.P., Gentile, F., Jneid, H., Krieger, E.V., and Mack, M. (2021). 2020 ACC\/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiolo-gy\/American Heart Association Joint Committee on Clinical Practice Guidelines. J. Thorac. Cardiovasc. Surg., 162, e183\u2013e353."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e006179","DOI":"10.1161\/CIRCINTERVENTIONS.117.006179","article-title":"Transcatheter Versus Surgical Aortic Valve Re-placement in Patients with Prior Coronary Artery Bypass Grafting: Trends in Utilization and Propensity-Matched Analysis of In-Hospital Outcomes","volume":"11","author":"Gupta","year":"2018","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1001\/jama.2014.3316","article-title":"Comparison of balloon-expandable vs self-expandable valves in patients undergoing transcatheter aortic valve replacement: The CHOICE randomized clinical trial","volume":"311","author":"Mehilli","year":"2014","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.jcin.2018.12.019","article-title":"The \u201cBig Five\u201d Complications After Transcatheter Aortic Valve Replacement: Do We Still Have to Be Afraid of Them?","volume":"12","author":"Grube","year":"2019","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_15","first-page":"E199","article-title":"A Direct Comparison of Self-Expandable Portico Versus Balloon-Expandable Sapien 3 Devices for Transcatheter Aortic Valve Replacement: A Case-Matched Cohort Study","volume":"31","author":"Seppelt","year":"2019","journal-title":"J. Invasive Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"777","DOI":"10.7326\/M14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: Checklist and explanations","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/096228029600500402","article-title":"Markov chain Monte Carlo methods in biostatistics","volume":"5","author":"Gelman","year":"1996","journal-title":"Stat Methods Med Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.jcin.2019.12.026","article-title":"5-Year Outcomes After TAVR With Balloon-Expandable Versus Self-Expanding Valves: Results from the CHOICE Randomized Clinical Trial","volume":"13","author":"Landt","year":"2020","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1016\/j.jacc.2018.08.2146","article-title":"5-Year Outcomes of Self-Expanding Transcatheter Versus Surgical Aortic Valve Replacement in High-Risk Patients","volume":"72","author":"Gleason","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e910","DOI":"10.1161\/CIRCULATIONAHA.120.047270","article-title":"Response by Vincent et al to Letter Regarding Article, \u201cBalloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Replacement: A Propensity-Matched Comparison From the FRANCE-TAVI Registry\u201d","volume":"141","author":"Vincent","year":"2020","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1002\/ccd.25866","article-title":"A comparison of transcatheter aortic valve implantation and surgical aortic valve replacement in 1,141 patients with severe symptomatic aortic stenosis and less than high risk","volume":"86","author":"Schymik","year":"2015","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1016\/j.jcin.2017.06.026","article-title":"Multicenter Comparison of Novel Self-Expanding Versus Balloon-Expandable Transcatheter Heart Valves","volume":"10","author":"Husser","year":"2017","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1007\/s00392-018-1372-6","article-title":"Efficacy and safety of new-generation transcatheter aortic valves: Insights from the Israeli transcatheter aortic valve replacement registry","volume":"108","author":"Finkelstein","year":"2018","journal-title":"Clin. Res. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/j.jacc.2018.08.1033","article-title":"Transcatheter Aortic Valve Replacement in Low-Risk Patients with Symptomatic Severe Aortic Stenosis","volume":"72","author":"Waksman","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2714","DOI":"10.1161\/CIRCULATIONAHA.118.036606","article-title":"Five-Year Clinical and Echocardiographic Outcomes from the NOTION Randomized Clinical Trial in Patients at Lower Surgical Risk","volume":"139","author":"Thyregod","year":"2019","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0140-6736(20)31358-1","article-title":"Self-expanding intra-annular versus commercially available transcatheter heart valves in high and extreme risk patients with severe aortic stenosis (PORTICO IDE): A randomised, controlled, non-inferiority trial","volume":"396","author":"Makkar","year":"2020","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1016\/S0140-6736(15)60308-7","article-title":"5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): A ran-domised controlled trial","volume":"385","author":"Mack","year":"2015","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa1910555","article-title":"Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement","volume":"382","author":"Makkar","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.jacc.2020.12.052","article-title":"Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk","volume":"77","author":"Leon","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1161\/CIRCULATIONAHA.120.051547","article-title":"Comparison of Self-Expanding Bio-prostheses for Transcatheter Aortic Valve Replacement in Patients with Symptomatic Severe Aortic Stenosis: SCOPE 2 Ran-domized Clinical Trial","volume":"142","author":"Tamburino","year":"2020","journal-title":"Circulation"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/S0140-6736(19)32220-2","article-title":"Safety and efficacy of a self-expanding versus a balloon-expandable bioprosthesis for transcatheter aortic valve replacement in patients with symptomatic severe aortic ste-nosis: A randomised non-inferiority trial","volume":"394","author":"Lanz","year":"2019","journal-title":"Lancet"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.jacc.2021.03.007","article-title":"Impact of Anesthesia Strategy and Valve Type on Clinical Outcomes After Transcatheter Aortic Valve Replacement","volume":"77","author":"Feistritzer","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_35","first-page":"541","article-title":"Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world","volume":"23","author":"Castrodeza","year":"2016","journal-title":"Cardiol. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1016\/j.amjcard.2017.07.097","article-title":"Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Lower-Surgical-Risk Patients with Chronic Obstructive Pulmonary Disease","volume":"120","author":"Auffret","year":"2017","journal-title":"Am. J. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.ahj.2012.09.005","article-title":"Transcatheter vs surgical aortic valve re-placement in intermediate-surgical-risk patients with aortic stenosis: A propensity score-matched case-control study","volume":"164","author":"Latib","year":"2012","journal-title":"Am. Heart J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1093\/ejcts\/ezz245","article-title":"Transcatheter aortic valve implantation versus surgical aortic valve replacement in low-risk patients: A propensity score-matched analysis","volume":"56","author":"Schaefer","year":"2019","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1016\/S0140-6736(16)30073-3","article-title":"Transcatheter aortic valve re-placement versus surgical valve replacement in intermediate-risk patients: A propensity score analysis","volume":"387","author":"Thourani","year":"2016","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.amjcard.2020.01.015","article-title":"Comparison of Valve Durability and Outcomes of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients with Severe Symptomatic Aortic Stenosis and Less-Than-High-Risk for Surgery","volume":"125","author":"Tzamalis","year":"2020","journal-title":"Am. J. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e020906","DOI":"10.1161\/JAHA.121.020906","article-title":"Predictors of Permanent Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement\u2014A Systematic Review and Meta-Analysis","volume":"10","author":"Ullah","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.carrev.2017.07.006","article-title":"Comparison of outcomes in new-generation versus early-generation heart valve in transcatheter aortic valve implantation: A systematic review and meta-analysis","volume":"19","author":"Ando","year":"2018","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1007\/s00380-019-01442-w","article-title":"Network meta-analysis of new-generation valves for transcatheter aortic valve implantation","volume":"34","author":"Takagi","year":"2019","journal-title":"Heart Vessel."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Fang, F., Tang, J., Zhao, Y., He, J., Xu, P., and Faramand, A. (2019). Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients at low and intermediate risk: A risk specific meta-analysis of randomized controlled trials. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0221922"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.amjcard.2019.07.029","article-title":"Meta-Analysis Comparing Transcatheter Aortic Valve Implantation to Surgical Aortic Valve Replacement in Low Surgical Risk Patients","volume":"124","author":"Saleem","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1093\/eurheartj\/ehz275","article-title":"Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: An updated meta-analysis","volume":"40","author":"Siontis","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zahid, S., Ullah, W., Khan, M.Z., Uddin, M.F., Rai, D., Abbas, S., Hussein, A., Salama, A., Bandyopadhyay, D., and Bhaibhav, B. (2022). Cerebral Embolic Protection during Transcatheter Aortic Valve Implantation: Updated Systematic Review and Meta-Analysis. Curr Probl Cardiol., 101127.","DOI":"10.1016\/j.cpcardiol.2022.101127"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e009407","DOI":"10.1161\/CIRCINTERVENTIONS.120.009407","article-title":"Systematic Approach to High Implantation of SAPIEN-3 Valve Achieves a Lower Rate of Conduction Abnormalities Including Pacemaker Implantation","volume":"14","author":"Sammour","year":"2021","journal-title":"Circ. Cardiovasc. Interv."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5299\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:27:54Z","timestamp":1760142474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/18\/5299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,8]]},"references-count":48,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11185299"],"URL":"https:\/\/doi.org\/10.3390\/jcm11185299","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,9,8]]}}}