{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:04:35Z","timestamp":1764842675703,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: One of the leading causes of mortality and morbidity in people over the age of 50 is stroke. The acceptance of transcatheter aortic valve replacement (TAVR) as a treatment option for severe symptomatic aortic stenosis (AS) has increased as a result of numerous randomized clinical trials comparing surgical aortic valve replacement (SAVR) and TAVR in high- and intermediate-risk patients, showing comparable clinical outcomes and valve hemodynamics. Materials and Methods: An electronic search of Medline, Google Scholar and Cochrane Central was carried out from their inception to 28 September 2022 without any language restrictions. Results: Our meta-analysis demonstrated that, as compared with SAVR, TAVR was not linked with a lower stroke ratio or stroke mortality. It is clear from this that the SAVR intervention techniques applied in the six studies were successful in reducing cardiogenic consequences over time. Conclusions: A significantly decreased rate of mortality from cardiogenic causes was associated with SAVR. Additionally, when TAVR and SAVR were compared for stroke mortality, the results were nonsignificant with a p value of 0.57, indicating that none of these procedures could decrease stroke-related mortality.<\/jats:p>","DOI":"10.3390\/medicina59010012","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T04:28:55Z","timestamp":1671596935000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement for Long-Term Mortality Due to Stroke and Myocardial Infarction: A Meta-Analysis during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2555-3624","authenticated-orcid":false,"given":"Alexandru Cristian","family":"Ion","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department 5, Cardiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Cardiology Department, Bagdasar Arseni Emergency Hospital, 041915 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5081-2478","authenticated-orcid":false,"given":"Liviu Ionut","family":"Serbanoiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department 5, Cardiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Cardiology Department, Bagdasar Arseni Emergency Hospital, 041915 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Plesu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department 5, Cardiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Cardiology Department, Bagdasar Arseni Emergency Hospital, 041915 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4678-9655","authenticated-orcid":false,"given":"Stefan Sebastian","family":"Busnatu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department 5, Cardiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Cardiology Department, Bagdasar Arseni Emergency Hospital, 041915 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina Liliana","family":"Andrei","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department 5, Cardiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Cardiology Department, Bagdasar Arseni Emergency Hospital, 041915 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.1212\/WNL.0000000000013115","article-title":"Global, Regional, and National Burden of Ischemic Stroke, 1990\u20132019","volume":"98","author":"Ding","year":"2022","journal-title":"Neurology"},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2022, December 11). (2022, October 14) Heart Disease Facts. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/heartdisease\/facts.htm."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1161\/STROKEAHA.119.028389","article-title":"Incidence of Ischemic Stroke in Individuals with and Without Aortic Valve Stenosis: A Danish Retrospective Cohort Study","volume":"51","author":"Andreasen","year":"2020","journal-title":"Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jaakkola, J., Jaakkola, S., Airaksinen, K.E.J., Husso, A., Juvonen, T., Laine, M., Virtanen, M., Maaranen, P., Niemel\u00e4, M., and M\u00e4kikallio, T. (2020). Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0238953"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1161\/STROKEAHA.114.005296","article-title":"Stroke in Patients with Aortic Stenosis. The Simvastatin and Ezetimibe in Aortic Stenosis Study","volume":"45","author":"Greve","year":"2014","journal-title":"Stroke"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1093\/eurheartj\/ehu247","article-title":"Aortic stenosis and coronary artery disease: What do we know? What don\u2019t we know? A comprehensive review of the literature with proposed treatment algorithms","volume":"35","author":"Paradis","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S0021-9150(01)00617-7","article-title":"Nonobstructive aortic valve calcification: A window to significant coronary artery disease","volume":"161","author":"Adler","year":"2002","journal-title":"Atherosclerosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S0735-1097(99)00584-7","article-title":"Observed and relative survival after aortic valve replacement","volume":"35","author":"Kvidal","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1152\/japplphysiol.00049.2008","article-title":"Impairment of coronary flow reserve in aortic stenosis","volume":"106","author":"Garcia","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1161\/hc0402.102931","article-title":"Mechanisms of coronary microcirculatory dysfunction in patients with aortic stenosis and angiographically normal coronary arteries","volume":"105","author":"Rajappan","year":"2002","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9593","DOI":"10.1038\/s41598-021-89217-0","article-title":"Late stroke after transcatheter aortic valve replacement: A nationwide study","volume":"11","author":"Bjursten","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jcin.2015.01.020","article-title":"Incidence and predictors of debris embolizing to the brain during transcatheter aortic valve implantation","volume":"8","author":"Rahhab","year":"2015","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_13","unstructured":"Sender, S.J., Kohli, P., Sharma, G., and Blumenthal, R.S. (2022). COVID-19\u2019s Impact on Heart Disease and Stroke Mortality, American College of Cardiology. Expert Analysis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e223872","DOI":"10.1001\/jamanetworkopen.2022.3872","article-title":"Age-adjusted mortality rates and age and risk\u2013associated contributions to change in heart disease and stroke mortality, 2011\u20132019 and 2019\u20132020","volume":"5","author":"Sidney","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery","volume":"363","author":"Leon","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1056\/NEJMoa1103510","article-title":"Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients","volume":"364","author":"Smith","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1056\/NEJMoa1400590","article-title":"Transcatheter Aortic-Valve Replacement with a Self-Expanding Prosthesis","volume":"370","author":"Adams","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_18","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_19","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1080\/07853890.2019.1614657","article-title":"Ten-year experience with transcatheter and surgical aortic valve replacement in Finland","volume":"51","author":"Jalava","year":"2019","journal-title":"Ann. Med."},{"key":"ref_20","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_21","doi-asserted-by":"crossref","first-page":"e010413","DOI":"10.1161\/CIRCINTERVENTIONS.120.010413","article-title":"Indirect Impact of the COVID-19 Pandemic on Activity and Outcomes of Transcatheter and Surgical Treatment of Aortic Stenosis in England","volume":"14","author":"Martin","year":"2021","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1093\/ejcts\/ezv270","article-title":"Activity and outcomes for aortic valve implantations performed in England and Wales since the introduction of transcatheter aortic valve implantation","volume":"49","author":"Grant","year":"2015","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1177\/1474515120934057","article-title":"Facilitating transcatheter aortic valve implantation in the era of COVID-19: Recommendations for programmes","volume":"19","author":"Lauck","year":"2020","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e010407","DOI":"10.1161\/JAHA.118.010407","article-title":"Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes","volume":"8","author":"Yarranton","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e059309","DOI":"10.1136\/bmjopen-2021-059309","article-title":"Aortic stenosis post-COVID-19: A mathematical model on waiting lists and mortality","volume":"12","author":"Stickels","year":"2022","journal-title":"BMJ Open"},{"key":"ref_26","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_27","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jtcvs.2018.11.129","article-title":"Causes of death in intermediate-risk patients: The Randomized Surgical Replacement and Transcatheter Aortic Valve Implantation Trial","volume":"158","author":"Amrane","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.1016\/j.jcin.2018.08.006","article-title":"Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial","volume":"11","author":"Chen","year":"2018","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_29","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_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":"2485","DOI":"10.1016\/S0140-6736(15)60290-2","article-title":"5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): A randomised controlled trial","volume":"385","author":"Kapadia","year":"2015","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2714","DOI":"10.1161\/CIRCULATIONAHA.118.036606","article-title":"Five-Year Clinical and Echocardiographic Outcomes from the Nordic Aortic Valve Intervention (NOTION) Randomized Clinical Trial in Lower Surgical Risk Patients","volume":"139","author":"Thyregod","year":"2019","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1016\/j.jacc.2019.06.076","article-title":"Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients","volume":"74","author":"Kolte","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"590975","DOI":"10.3389\/fcvm.2020.590975","article-title":"Efficacy and Safety of Transcatheter vs. Surgical Aortic Valve Replacement in Low-to-Intermediate-Risk Patients: A Meta-Analysis","volume":"7","author":"Lou","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1093\/eurheartj\/ehab375","article-title":"Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement","volume":"42","author":"Thyregod","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_36","first-page":"101125","article-title":"Early surgery vs. conservative management among asymptomatic aortic stenosis: A systematic review and meta-analysis","volume":"43","author":"Jaiswal","year":"2022","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.carrev.2019.08.009","article-title":"Cardiovascular Outcomes with Transcatheter vs. Surgical Aortic Valve Replacement in Low-Risk Patients: An Updated Meta-Analysis of Randomized Controlled Trials","volume":"21","author":"Kundu","year":"2020","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/jocs.15181","article-title":"COVID-19 and its implications on patient selection for TAVI and SAVR: Are we heading into a new era?","volume":"36","author":"Harky","year":"2021","journal-title":"J. Card. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1111\/jocs.15439","article-title":"SAVR contemporary outcomes in TAVI era: Still a valid option for the future","volume":"36","author":"Khalil","year":"2021","journal-title":"J. Card. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"512","DOI":"10.12680\/balneo.2022.512","article-title":"The Impact of Antithrombotic Therapy in Patients with Decompensated Heart Failure and Iron","volume":"13","author":"Cristian","year":"2022","journal-title":"Balneo PRM Res. J."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:45:11Z","timestamp":1760147111000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,21]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["medicina59010012"],"URL":"https:\/\/doi.org\/10.3390\/medicina59010012","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2022,12,21]]}}}