Postoperative delirium in patients undergoing TAVI versus SAVR - A systematic review and meta-analysis

Background: Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) have different levels of invasiveness which can result in different levels of functional status after the procedure. Methods: We performed a systematic review and meta-analysis to detect studies showing direct comparison between TAVI and SAVR regarding postoperative functional status. The primary endpoint was the incidence of postoperative delirium (POD) after TAVI or SAVR, assessed using the Confusion Assessment Method (CAM). Secondary endpoints included 30-day mortality, stroke, major bleeding, and hospital length of stay (LOS). Results: We identified 1,161 manuscripts, of which 10 studies (12,015 patients) were analyzed. TAVI patients had a significantly lower incidence of POD (OR: 0.35, 95 % CI, 0.26-0.48, p < 0.01) compared to SAVR patients. No significant differences were found in secondary outcomes between the groups. Conclusions: TAVI is associated with a lower incidence of postoperative delirium compared to SAVR without compromising length of stay or other major clinical outcomes. Further research is needed to understand the impact of postoperative delirium on short and long-term outcomes.