TAVR vs. SAVR in patients with severe aortic stenosis and chronic kidney disease undergoing dialysis: A comprehensive meta-analysis

Authors

• Maneeth Mylavarapu, Department of Cardiology, Endeavor Health Cardiovascular Institute, Endeavor Health Glenbrook Hospital, Glenview, Illinois, 60026, USA.
• Madiha Kiyani, Department of Internal Medicine, MedStar Health, Georgetown University, Washington, District of Columbia, 20007, USA, georgetown.edu.
• Niharika Tanwar, Advocate Health - MidwestFollow
• Meghana Reddy, Department of Internal Medicine, Mysore Medical College & Research Institute, Mysuru, Karnataka, 570001, India, mysoremedicalcollege.com.
• Israel Garcia, Department of Family Medicine, University of Southern California School of Medicine, Los Angeles, California, 90033, USA, usc.edu.
• Nithin Karnan, Department of Internal Medicine, MercyOne North Iowa Medical Center, Mason City, Iowa, 50401, USA.
• Nidhi Laxminarayan Rao, Department of Internal Medicine, Adventist Health Bakersfield, Bakersfield, California, 93301, USA, adventisthealth.org.
• Lakshmi Sai Kodali, Department of Public Health & Health Sciences, University of Michigan - Flint, Flint, Michigan, 48502, USA.
• Nimisha Borra, Department of Internal Medicine, Kamineni Academy of Medical Sciences & Research Center, Hyderabad, Telangana, 500074, India.

Recommended Citation

Mylavarapu M, Kiyani M, Tanwar N, et al. TAVR vs. SAVR in Patients With Severe Aortic Stenosis and Chronic Kidney Disease Undergoing Dialysis: A Comprehensive Meta-Analysis. Cardiol Res Pract. 2026;2026:9451268. Published 2026 Jun 19. doi:10.1155/crp/9451268

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: Patients with chronic kidney disease (CKD) undergoing dialysis who also suffer from severe aortic stenosis (AS) present a complex management challenge. Both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are treatment options, but comparative outcomes in this specific, high-risk population continue to remain unclear.

Aim: This study aims to compare TAVR and SAVR postoperative clinical outcomes in patients with severe AS and CKD undergoing dialysis.

Methods: According to PRISMA guidelines, a comprehensive search was conducted across various databases such as PubMed, EMBASE, Scopus, and Google Scholar. Original studies that compared the clinical outcomes between TAVR and SAVR in patients with severe AS and CKD undergoing dialysis were included in the study.

Results: Ten studies, all retrospective, involving 28,625 (14,625 TAVR and 14,000 SAVR) patients with severe AS and CKD undergoing dialysis who underwent TAVR or SAVR were included in this study. Patients who underwent TAVR had significantly lower odds of in-hospital mortality (OR 0.49; 0.29, 0.84; p = 0.01) and shorter length of stay (LOS) (SMD -2.59; 95% CI -5.04, -0.14; p ≤ 0.04). However, the TAVR group had significantly higher odds of permanent pacemaker implantation (OR 2.25; 95% CI 1.71-2.94; p < 0.00001).

Conclusion: In patients with severe AS and CKD undergoing dialysis, TAVR is associated with lower in-hospital mortality and shorter LOS, suggesting a favorable early safety profile and recovery in this population.

Type

Article

PubMed ID

42325936