Safety and efficacy of transcatheter aortic valve implantation in stenotic bicuspid aortic valve compared to tricuspid aortic valve: a systematic review and meta-analysis.
AS
Aortic stenosis
BAV
TAV
TAVI
bicuspid aortic valve
transcatheter aortic valve implantation
tricuspid aortic valve
Journal
Expert review of cardiovascular therapy
ISSN: 1744-8344
Titre abrégé: Expert Rev Cardiovasc Ther
Pays: England
ID NLM: 101182328
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
pubmed:
1
7
2022
medline:
19
8
2022
entrez:
30
6
2022
Statut:
ppublish
Résumé
Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective alternative to surgical replacement for tricuspid aortic valve (TAV) stenosis. However, utilization of TAVI for aortic stenosis in bicuspid aortic valve (BAV) compared to TAV remains controversial. We queried online databases with various keywords to identify relevant articles. We compared major cardiovascular events and procedural outcomes using a random effect model to calculate odds ratios (OR). We included a total of 22 studies comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled analysis, there were no difference in TAVI for BAV vs. TAV for all-cause mortality, cardiovascular mortality, myocardial infarction (MI), vascular complications, acute kidney injury (AKI), coronary occlusion, annulus rupture, and reintervention/reoperation between the groups. The incidence of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42; 95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26) was less in the TAV group compared to the BAV group, while incidence of life-threatening bleeding was higher in the TAV group. Subgroup analysis mirrored pooled outcomes except for all-cause mortality. The use of TAVI for the treatment of aortic stenosis in selective BAV appears to be safe and effective.
Sections du résumé
BACKGROUND
UNASSIGNED
Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective alternative to surgical replacement for tricuspid aortic valve (TAV) stenosis. However, utilization of TAVI for aortic stenosis in bicuspid aortic valve (BAV) compared to TAV remains controversial.
METHODS
UNASSIGNED
We queried online databases with various keywords to identify relevant articles. We compared major cardiovascular events and procedural outcomes using a random effect model to calculate odds ratios (OR).
RESULTS
UNASSIGNED
We included a total of 22 studies comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled analysis, there were no difference in TAVI for BAV vs. TAV for all-cause mortality, cardiovascular mortality, myocardial infarction (MI), vascular complications, acute kidney injury (AKI), coronary occlusion, annulus rupture, and reintervention/reoperation between the groups. The incidence of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42; 95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26) was less in the TAV group compared to the BAV group, while incidence of life-threatening bleeding was higher in the TAV group. Subgroup analysis mirrored pooled outcomes except for all-cause mortality.
CONCLUSION
UNASSIGNED
The use of TAVI for the treatment of aortic stenosis in selective BAV appears to be safe and effective.
Identifiants
pubmed: 35770517
doi: 10.1080/14779072.2022.2094368
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM