Journal article
Meta-Analysis of Valve-in-Valve Transcatheter Aortic Valve Implantation Versus Redo-surgical Aortic Valve Replacement in Failed Bioprosthetic Aortic Valve
The American journal of cardiology, Vol.146, pp.74-81
05/01/2021
DOI: 10.1016/j.amjcard.2021.01.028
PMID: 33529615
Abstract
This meta-analysis was conducted to compare clinical outcomes of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-surgical aortic valve replacement (Redo-SAVR) in failed bioprosthetic aortic valves. We conducted a comprehensive review of previous publications of all relevant studies through August 2020. Twelve observational studies were included with a total of 8,430 patients, and a median-weighted follow-up period of 1.74 years. A pooled analysis of the data showed no significant difference in all-cause mortality (OR 1.15; 95% CI 0.93 to 1.43; p = 0.21), cardiovascular mortality, myocardial infarction, permanent pacemaker implantation, and the rate of moderate to severe paravalvular leakage between ViV-TAVI and Redo-SAVR groups. The rate of major bleeding (OR 0.36; 95% CI 0.16 to 0.83, p = 0.02), procedural mortality (OR 0.41; 95% CI 0.18 to 0.96, p = 0.04), 30-day mortality (OR 0.58; 95% CI 0.45 to 0.74, p <0.0001), and the rate of stroke (OR 0.65; 95% CI 0.52 to 0.81, p = 0.0001) were significantly lower in the ViV- TAVI arm when compared with Redo-SAVR arm. The mean transvalvular pressure gradient was significantly higher post-implantation in the ViV-TAVI group when compared with the Redo-SAVR arm (Mean difference 3.92; 95% CI 1.97 to 5.88, p < 0.0001). In conclusion, compared with Redo-SAVR, ViV-TAVI is associated with a similar risk of all-cause mortality, cardiovascular mortality, myocardial infarction, permanent pacemaker implantation, and the rate of moderate to severe paravalvular leakage. However, the rate of major bleeding, stroke, procedural mortality and 30-day mortality were significantly lower in the ViV-TAVI group when compared with Redo-SAVR.
Details
- Title: Subtitle
- Meta-Analysis of Valve-in-Valve Transcatheter Aortic Valve Implantation Versus Redo-surgical Aortic Valve Replacement in Failed Bioprosthetic Aortic Valve
- Creators
- Abdullah Al-abcha - Michigan State UniversityYehia Saleh - Houston MethodistManel Boumegouas - Michigan State UniversityRohan Prasad - Michigan State UniversityKhader Herzallah - Tufts Medical CenterZulfiqar Qutrio Baloch - Michigan State UniversityOla Abdelkarim - Alexandria UniversitySupratik Rayamajhi - Michigan State UniversityGeorge S Abela - Michigan State University
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.146, pp.74-81
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjcard.2021.01.028
- PMID
- 33529615
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Number of pages
- 8
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984756266602771
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