Transcatheter vs Surgical Aortic Valve Replacement Outcomes Among Solid Organ Transplant Patients: A Systematic Review and Meta-Analysis

The safety and clinical outcomes of trans-catheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) among patients with solid organ transplants is not well under-stood. This study aimed to evaluate the clinical out-comes of TAVR and SAVR among patients with a history of solid organ transplantation. We performed a systematic literature search of databases for relevant articles from inception until May 1st, 2022. Unad-justed odds ratios (OR) were pooled using a random -effect model, and a P-value of <0.05 was considered statistically significant. A total of 3240 studies were identified of which 3 studies with a total of 2960 patients were included in the final analysis. For solid organ transplants patients, the odds of in-hospital mortality (OR 0.37, 95% CI 0.20-0.71, P < 0.001), 30 -day mortality (OR 0.51, 95% CI 0.35-0.74, P < 0.001), acute kidney injury (OR 0.45, 95% CI 0.35-0.59, P < 0.001), and bleeding (OR 0.35, 95% CI 0.27-0.46, P < 0.001) were significantly lower in patients undergoing TAVR compared to SAVR. In contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36-18.90, P = 0.34), postprocedural stroke (OR 0.36, 95% CI 0.13-1.03, P = 0.06) were similar between both groups of patients. Length of hospital stay was significantly lower in TAVR compared to SAVR patients (SMD-0.82, 95% CI-0.95 to-0.70, P < 0.001). In solid organ transplant patients, TAVR appeared to be a safe pro-cedure with fewer postprocedure complications, shorter length of hospital stay, and lower in hospital mortality compared with SAVR. (Curr Probl Cardiol 2023;48:101685.)

Automated summary

This study aimed to evaluate the clinical outcomes of trans-catheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) among patients with a history of solid organ transplantation. The study found that compared to SAVR, TAVR was associated with lower in-hospital mortality, 30-day mortality, acute kidney injury, bleeding, and shorter length of hospital stay among solid organ transplant patients.