Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: A Systematic Review of Long-Term Outcomes

The role of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) continues to expand, yet uncertainty remains regarding the long-term outcomes in low-risk populations compared with surgical aortic valve replacement (SAVR). This systematic review examined long-term mortality, stroke, postoperative complications, and valve durability across randomized and observational studies. Randomized data showed similar long-term survival and stroke rates between TAVR and SAVR, while observational studies suggested worse late outcomes following TAVR. TAVR was consistently associated with fewer postoperative complications, whereas durability and re-intervention findings varied across studies. Overall, these results suggest that while TAVR offers meaningful advantages, treatment decisions should be individualized to balance a patient's comorbidities with long-term procedural outcomes.