Patients with MAVD demonstrated long-term survival comparable to those with predominant AS following transcatheter aortic valve replacement (TAVR), according to findings published in The American Journal of Cardiology.

This study-level meta-analysis reconstructed time-to-event data from 10 non-randomized studies that included a total of 7,340 patients, of whom 4,263 had AS and 3,077 had MAVD. MAVD was defined as severe AS with at least mild or moderate concomitant aortic regurgitation. At five years, overall survival was comparable between groups (hazard ratio [HR] 1.03; 95% confidence interval [CI] 0.94–1.14).

A sensitivity analysis restricted to studies involving patients with moderate or greater regurgitation confirmed no survival difference (HR 0.97; 95% CI 0.84–1.12). In contrast, among propensity-matched cohorts representing 35% of the study population, patients with MAVD showed improved survival (HR 0.79; 95% CI 0.65–0.94). Post-TAVR paravalvular leak occurred more frequently in the MAVD group (risk ratio 1.64; 95% CI 1.15–2.33).

These findings emphasize the consistent cardioprotective benefits of SGLT2 inhibitors across revascularization groups.