{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:52:40Z","timestamp":1791237160039,"version":"4.1.0"},"reference-count":93,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Transcatheter aortic valve replacement (TAVR) has been introduced as an optimal treatment for patients with severe aortic stenosis, offering a minimally invasive alternative to surgical aortic valve replacement. Predicting these outcomes following TAVR is crucial. Artificial intelligence (AI) has emerged as a promising tool for improving post-TAVR outcome prediction. In this systematic review and meta-analysis, we aim to summarize the current evidence on utilizing AI in predicting post-TAVR outcomes. Methods: A comprehensive search was conducted to evaluate the studies focused on TAVR that applied AI methods for risk stratification. We assessed various ML algorithms, including random forests, neural networks, extreme gradient boosting, and support vector machines. Model performance metrics\u2014recall, area under the curve (AUC), and accuracy\u2014were collected with 95% confidence intervals (CIs). A random-effects meta-analysis was conducted to pool effect estimates. Results: We included 43 studies evaluating 366,269 patients (mean age 80 \u00b1 8.25; 52.9% men) following TAVR. Meta-analyses for AI model performances demonstrated the following results: all-cause mortality (AUC = 0.78 (0.74\u20130.82), accuracy = 0.81 (0.69\u20130.89), and recall = 0.90 (0.70\u20130.97); permanent pacemaker implantation or new left bundle branch block (AUC = 0.75 (0.68\u20130.82), accuracy = 0.73 (0.59\u20130.84), and recall = 0.87 (0.50\u20130.98)); valve-related dysfunction (AUC = 0.73 (0.62\u20130.84), accuracy = 0.79 (0.57\u20130.91), and recall = 0.54 (0.26\u20130.80)); and major adverse cardiovascular events (AUC = 0.79 (0.67\u20130.92)). Subgroup analyses based on the model development approaches indicated that models incorporating baseline clinical data, imaging, and biomarker information enhanced predictive performance. Conclusions: AI-based risk prediction for TAVR complications has demonstrated promising performance. However, it is necessary to evaluate the efficiency of the aforementioned models in external validation datasets.<\/jats:p>","DOI":"10.3390\/jpm15070302","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T08:15:47Z","timestamp":1752221747000},"page":"302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Artificial Intelligence in Risk Stratification and Outcome Prediction for Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Shayan","family":"Shojaei","sequence":"first","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"},{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1936893813, Iran"},{"name":"Students\u2019 Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Mousavi","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"},{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1936893813, Iran"},{"name":"Students\u2019 Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2559-0858","authenticated-orcid":false,"given":"Sina","family":"Kazemian","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7115-242X","authenticated-orcid":false,"given":"Shiva","family":"Armani","sequence":"additional","affiliation":[{"name":"Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 7346181746, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8476-6163","authenticated-orcid":false,"given":"Saba","family":"Maleki","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parisa","family":"Fallahtafti","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0953-7686","authenticated-orcid":false,"given":"Farzin Tahmasbi","family":"Arashlow","sequence":"additional","affiliation":[{"name":"Medical Students Research Centre, Iran University of Medical Sciences, Tehran 1449614535, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasaman","family":"Daryabari","sequence":"additional","affiliation":[{"name":"Pediatric Urology and Regenerative Medicine Research Center, Children\u2019s Medical Center, Gene, Cell & Tissue Research Institute, Tehran University of Medical Sciences, Tehran 1419733151, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Naderian","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Alkhouli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Division of Cardiovascular Diseases, Department of Medicine, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal S.","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA 94611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Mehrani","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser","family":"Jenab","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveh","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5603\/KP.2018.0013","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"76","author":"Baumgartner","year":"2018","journal-title":"Pol. 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