Comparison of early and midterm outcomes after transsubclavian/axillary versus transfemoral, transapical, or transaortic transcatheter aortic valve implantation.

Aortic Valve / surgery Heart Valve Prosthesis Humans Time Factors Transcatheter Aortic Valve Replacement / methods Treatment Outcome
Meta-analysis Transaortic transcatheter aortic valve implantation Transapical transcatheter aortic valve implantation Transfemoral transcatheter aortic valve implantation Transsubclavian/transaxillary transcatheter aortic valve implantation

Journal

Heart & lung : the journal of critical care
ISSN: 1527-3288
Titre abrégé: Heart Lung
Pays: United States
ID NLM: 0330057

Informations de publication

Date de publication:
Historique:
received: 03 01 2019
revised: 30 03 2019
accepted: 05 04 2019
pubmed: 12 5 2019
medline: 31 3 2020
entrez: 12 5 2019
Statut: ppublish

Résumé

Outcomes after transsubclavian/transaxillary (TSc/TAx)-transcatheter aortic valve implantation (TAVI) have been unclear. To compare outcomes after TSc/TAx-TAVI versus transfemoral (TF)-TAVI, transapical (TAp)-TAVI, or transaortic (TAo)-TAVI, we performed meta-analysis of currently available studies. Studies considered for inclusion met the following criteria: the study population was patients undergoing TAVI; patients were assigned to TSc/TAx-TAVI and TF-TAVI, TAp-TAVI, or TAo-TAVI; and at least one of postprocedural early (30-day or in-hospital) or late (including early) outcomes was reported. An odds or hazard ratio of each early or late outcome with its 95% confidence interval for TSc/TAx-TAVI versus the other approach was extracted from each individual study and combined in the random-effects model. Our search identified 15 eligible reports from 12 studies including 10,528 patients. Pooled analysis of early all-cause mortality demonstrated a statistically significant reduction after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.003) or TAo-TAVI (P = 0.03). Pooled analysis of early pacemaker implantation demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.0001) or TAo-TAVI (P < 0.00001). Pooled analysis of midterm all-cause mortality demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TF-TAVI (P = 0.007). Early all-cause mortality was lower after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, early pacemaker implantation was more frequent after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, and midterm all-cause mortality was higher after TSc/TAx-TAVI than TF-TAVI.

Sections du résumé

BACKGROUND
Outcomes after transsubclavian/transaxillary (TSc/TAx)-transcatheter aortic valve implantation (TAVI) have been unclear.
OBJECTIVES
To compare outcomes after TSc/TAx-TAVI versus transfemoral (TF)-TAVI, transapical (TAp)-TAVI, or transaortic (TAo)-TAVI, we performed meta-analysis of currently available studies.
METHODS
Studies considered for inclusion met the following criteria: the study population was patients undergoing TAVI; patients were assigned to TSc/TAx-TAVI and TF-TAVI, TAp-TAVI, or TAo-TAVI; and at least one of postprocedural early (30-day or in-hospital) or late (including early) outcomes was reported. An odds or hazard ratio of each early or late outcome with its 95% confidence interval for TSc/TAx-TAVI versus the other approach was extracted from each individual study and combined in the random-effects model.
RESULTS
Our search identified 15 eligible reports from 12 studies including 10,528 patients. Pooled analysis of early all-cause mortality demonstrated a statistically significant reduction after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.003) or TAo-TAVI (P = 0.03). Pooled analysis of early pacemaker implantation demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.0001) or TAo-TAVI (P < 0.00001). Pooled analysis of midterm all-cause mortality demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TF-TAVI (P = 0.007).
CONCLUSIONS
Early all-cause mortality was lower after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, early pacemaker implantation was more frequent after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, and midterm all-cause mortality was higher after TSc/TAx-TAVI than TF-TAVI.

Identifiants

DOI: 10.1016/j.hrtlng.2019.04.002 PMID: 31076179
pubmed: 31076179
pii: S0147-9563(19)30002-0
doi: 10.1016/j.hrtlng.2019.04.002
pii:
doi:

Types de publication

Comparative Study Journal Article Meta-Analysis Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

519-529

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Hisato Takagi (H)

Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan. Electronic address: kfgth973@ybb.ne.jp.

Yosuke Hari (Y)

Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Kouki Nakashima (K)

Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Toshiki Kuno (T)

Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, United States.

Tomo Ando (T)

Department of Cardiology, Detroit Medical Center, Detroit, MI, United States.

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Classifications MeSH

questionsmedicales.fr › Système cardiovasculaire › Coeur › Valves cardiaques › Valve aortique › Comparison of early and midterm outcomes after...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Prothèse valvulaire cardiaque › Comparison of early and midterm outcomes after...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparison of early and midterm outcomes after...
questionsmedicales.fr › Phénomènes physiques › Temps › Facteurs temps › Comparison of early and midterm outcomes after...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Remplacement valvulaire aortique par cathéter › Comparison of early and midterm outcomes after...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Comparison of early and midterm outcomes after...