ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Comparative Study of Transcatheter Aortic Valve Implantation Versus Conventional Surgical Aortic Valve Replacement in the Treatment of Severe Aortic Stenosis with Reverse Ventricular Remodeling
Provisionally accepted
- The Affiliated Hospital of Qingdao University, Qingdao, China
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Introduction: This study aimed to compare echocardiographic outcomes and analyze the changes in ventricular remodeling at different time points after surgery in patients with severe aortic stenosis (AS) undergoing either surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). Methods: This retrospective study consecutively enrolled 175 patients with severe AS who underwent either SAVR or TAVR. Transthoracic echocardiograms obtained at baseline, 30 days, and 1 year after the procedure were analyzed by multiple echocardiographers at our institution. Results:Compared to TAVR patients, SAVR patients (N=87) exhibited a more pronounced reduction in left ventricular end-systolic dimension (-0.5 ± 0.65 cm vs. -0.2 ± 0.47 cm, p < 0.001) and left ventricular end-diastolic dimension (-0.6 ± 0.64 cm vs. -0.3 ± 0.55 cm, p < 0.001) at the 1-month follow-up. A decrease in left ventricular mass was observed in both groups from baseline to 1 month postoperatively, with the SAVR group showing a significantly greater reduction (LV mass: -67.3 ± 59.31 g vs. -38.2 ± 46.49 g, p = 0.003; LVMI: -39.1 ± 33.93 g/m ² vs. -22.5 ± 27.08 g/m², p = 0.005). However, these differences were not sustained at the 1-year follow-up. SAVR patients experienced a transient decline in right ventricular function at 1 month, which recovered by 1 year postoperatively. At the 1-year follow-up, the TAVR group experienced a higher incidence of Major Adverse Cardiac Events (MACE) (p=0.01), despite showing significant improvement in the severity of both mitral and tricuspid regurgitation compared to baseline (p<0.001). Although pulmonary artery pressure improved in both groups after AVR, the SAVR group demonstrated significantly lower pressure at 1 year (p<0.001). Conclusion:In patients with severe aortic stenosis, SAVR was associated with more significant regression of left ventricular dimensions and mass at 1 month compared to TAVR, alongside a transient impairment of right ventricular function. By 1 year postoperatively, however, no significant differences in ventricular remodeling were observed between the two groups.
Keywords: SAVR - surgical aortic valve replacement, TAVR - transcatheter aortic valve replacement, Aortic stenosis (AS), Reverse ventricular remodeling, Echocardiography
Received: 24 Sep 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 LI, Yang, Yan, Chen and Chi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sumin Yang
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