TAVR vs. SAVR outcomes in patients with previous mediastinal irradiation
| Trial | Key findings |
|---|---|
| Elbadawi et al. [46] (2020) | TAVR was associated with lower in-hospital mortality (1.2% vs. 2.0%), lower rates of acute kidney injury, bleeding, respiratory complications, and shorter hospital stays relative to SAVR. However, TAVR was associated with higher rates of pacemaker insertion. |
| Yazdchi et al. [47] (2021) | SAVR had an operative mortality of 4.3% compared to 1.4% for TAVR. SAVR patients also had longer intensive care unit (ICU) duration and higher blood transfusion requirements. Both cohorts had similar rates of stroke and pacemaker implantation. |
| Nauffal et al. [48] (2021) | TAVR was associated with lower rates of postoperative atrial fibrillation, pneumonia, pleural effusion, renal failure, and bleeding compared to SAVR. Stroke/transient ischemic attack and pacemaker implantation were higher with TAVR. Thirty-day mortality, cardiovascular mortality, and hospital readmission in the TAVR group were 4.6%, 1.7%, and 10.9% compared with 3.6%, 1.6%, and 11.2% in the SAVR group, respectively. |
| Jørgensen et al. [56] (2021) | At the 8-year follow-up mark, the estimated composite outcome risk of all-cause mortality, stroke, or myocardial infarction (MI) was insignificant between TAVR and SAVR (54.5% vs. 54.8%). |
| Kodali et al. [57] (2012) | TAVR and SAVR had similar outcomes pertaining to mortality, symptom reduction, and improved valve hemodynamics. However, paravalvular regurgitation was more frequent after TAVR and was associated with increased mortality later. |
| Leon et al. [58] (2016) | TAVR resulted in larger aortic-valve areas than SAVR along with lower rates of acute kidney injury, severe bleeding, and new-onset atrial fibrillation. However, SAVR resulted in fewer major vascular complications and less paravalvular aortic regurgitation. |