Survival and Functional Recovery after Aortic Valve Replacement in Patients with Severe Aortic Stenosis

Background: Aortic stenosis (AS) is a common heart valve disease that causes significant left ventricular (LV) dysfunction. Surgical aortic valve replacement (SAVR) is standard for severe symptomatic AS, but transcatheter aortic valve replacement (TAVI) offers an alternative for high-risk patients. This study aims to compare the survival and LV functional recovery following SAVR and TAVI in patients with severe symptomatic AS. Methods: This prospective observational study included 60 patients with severe symptomatic AS, divided into two groups: 30 undergoing SAVR and 30 undergoing TAVI. Follow-up included assessment of survival, complications, and LV function three months post-procedure. Results: The mean gradient was higher in the SAVR group (13 ± 5 vs. 11 ± 4, P = 0.02), as was E/e' (16.2 ± 1.6 vs. 15.4 ± 1.4, P = 0.04). Both groups showed significant reductions in E/e' and PASP (P < 0.001 for both). Three-month follow-up showed no significant differences in complications, including renal complications, myocardial infarction, bleeding, stroke, or mortality (P > 0.05 for all). Univariate and multivariate analyses adjusted for age and gender revealed no significant differences between groups for overall complications (P = 0.551), renal complications (P = 0.539), myocardial infarction (P = 0.762), bleeding (P = 0.340), stroke (P = 0.835), and mortality (P = 0.551). Conclusion: Both SAVR and TAVI are effective treatments for severe symptomatic AS with comparable outcomes in terms of complications, LV functional recovery, and survival. TAVI does not present a significant advantage over SAVR in terms of short- and long-term outcomes.