700.54 Comparative Outcomes of TAVR Vs. SAVR for Patients With Prior CABG: A Meta-Analysis
Recommended Citation
Qureshi MA, Haseeb S, Ahmed O, Bakht D, Amir M, Saeed S, Srivastava K, Yasin Z, Bai S, Tariq H, Shahid A, Othman H. 700.54 Comparative Outcomes of TAVR Vs. SAVR for Patients With Prior CABG: A Meta-Analysis. JACC Cardiovasc Interv 2025; 18(4):S98-S99.
Document Type
Conference Proceeding
Publication Date
2-24-2025
Publication Title
JACC Cardiovasc Interv
Keywords
aged, aortic stenosis, aortic valve replacement, atrial fibrillation, cerebrovascular accident, complication, conference abstract, coronary artery bypass graft, human, incidence, medical history, meta analysis, mortality, pacemaker implantation, patient history of coronary artery bypass graft, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, surgery, systematic review, transcatheter aortic valve implantation
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement (SAVR) are treatments for severe aortic stenosis, especially in patients with a history of Coronary Artery Bypass Grafting (CABG). This meta-analysis compares the short and long-term outcomes of TAVR and SAVR, focusing on post-operative atrial fibrillation (AF), pacemaker implantation, and 1-year cardiovascular (CV) mortality, stroke, and major vascular complications. Methods: A systematic review and meta-analysis were conducted per PRISMA guidelines, including studies comparing TAVR and SAVR outcomes in CABG patients. Primary outcomes were post-operative AF, pacemaker implantation, and 1-year CV mortality, stroke, and major vascular complications. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed with the I2 statistic, and a p-value of <0.05 was considered significant. Results: Post-Operative AF: 3 studies (854 patients) showed a significantly lower incidence of AF in the TAVR group (OR: 0.15, 95% CI: 0.09-0.27, P < 0.00001).Pacemaker Implantation: 10 studies (15,790 patients) showed TAVR was associated with a higher risk of pacemaker implantation (OR: 2.41, 95% CI: 1.49-3.89, P = 0.0003).1-Year Outcomes: 5 studies (8,627 patients) showed no significant difference between TAVR and SAVR for 1-year CV mortality (OR: 0.84, P = 0.51), stroke (OR: 0.94, P = 0.80), or major vascular complications (OR: 1.72, P = 0.12). Conclusion: TAVR offers a lower incidence of post-operative AF but a higher risk of pacemaker implantation compared to SAVR. For 1-year CV mortality, stroke, and major vascular complications, TAVR and SAVR show comparable outcomes. Further studies with larger sample sizes are needed to confirm these findings and better understand long-term outcomes [Formula presented]
Volume
18
Issue
4
First Page
S98
Last Page
S99
