Comparative Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Elderly Patients With Severe Symptomatic Aortic Stenosis: A Systematic Review

Objectives: : Aortic stenosis is the most common valvular heart disease globally; while transcatheter aortic valve replacement (TAVR) has proven to be a competitive alternative to surgical aortic valve replacement (SAVR) and revolutionized treatment, its safety and efficacy fi cacy has yet to be comprehensively assessed against SAVR for certain subsets of aortic stenosis patients; therefore, this study aims to systematically analyze all the available clinical evidence from randomized clinical trials on TAVR versus SAVR among intermediate and low-risk patients with severe symptomatic aortic stenosis. Methodology: : We performed a systematic review of the randomized controlled trials (RCT), studies comparing TAVR and SAVR in low- and intermediate-risk patients were identified fi ed by a comprehensive search of the major databases. Mortality, stroke, length of stay, and other perioperative outcomes were assessed. Results: : A comprehensive screening of 14,384 records identified fi ed 9 studies, encompassing 8884 patients with a mean age of 77.76 years and 49.47% male. TAVR demonstrated a significantly fi cantly lower all-cause mortality at both 30 days and 1 year compared to SAVR, with comparable outcomes at 2 years, underscoring its potential for enhanced survival. Stroke incidence was markedly lower with TAVR at both 30 days and 1 year, highlighting its favorable neurological safety profile. fi le. Additionally, TAVR showed a reduced rate of myocardial infarction within the initial 30 days post-procedure. Prosthetic valve endocarditis rates remained low and comparable between the two approaches at both 30 days and 1 year. Notably, TAVR was associated with a significantly fi cantly shorter hospital stay, suggesting a faster recovery trajectory and improved patient throughput. These fi ndings collectively emphasize the superior efficacy fi cacy and safety profile fi le of TAVR over SAVR. Conclusion: : TAVR may serve as a viable therapeutic option for intermediate and low-risk patients with severe symptomatic aortic stenosis. Future research should focus on long-term outcomes and TAVR device durability, especially in younger, lower-risk populations.