Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis
<p>Transcatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials th...
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| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , , , , , |
| منشور في: |
2021
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| _version_ | 1864513555784531968 |
|---|---|
| author | Charbel Abi Khalil (14150028) |
| author2 | Barbara Ignatiuk (14152983) Guliz Erdem (5874002) Hiam Chemaitelly (439114) Fabio Barilli (14152986) Mohamed El-Shazly (1502728) Jassim Al Suwaidi (284932) Samar Aboulsoud (14150022) Markus Kofler (5563250) Lukas Stastny (14152989) Hani Jneid (5038451) Nikolaos Bonaros (388592) |
| author2_role | author author author author author author author author author author author |
| author_facet | Charbel Abi Khalil (14150028) Barbara Ignatiuk (14152983) Guliz Erdem (5874002) Hiam Chemaitelly (439114) Fabio Barilli (14152986) Mohamed El-Shazly (1502728) Jassim Al Suwaidi (284932) Samar Aboulsoud (14150022) Markus Kofler (5563250) Lukas Stastny (14152989) Hani Jneid (5038451) Nikolaos Bonaros (388592) |
| author_role | author |
| dc.creator.none.fl_str_mv | Charbel Abi Khalil (14150028) Barbara Ignatiuk (14152983) Guliz Erdem (5874002) Hiam Chemaitelly (439114) Fabio Barilli (14152986) Mohamed El-Shazly (1502728) Jassim Al Suwaidi (284932) Samar Aboulsoud (14150022) Markus Kofler (5563250) Lukas Stastny (14152989) Hani Jneid (5038451) Nikolaos Bonaros (388592) |
| dc.date.none.fl_str_mv | 2021-06-07T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1038/s41598-021-91548-x |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Aortic_valve_function_post-replacement_of_severe_aortic_stenosis_by_transcatheter_procedure_versus_surgery_a_systematic_review_and_metanalysis/21598251 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Cardiac device therapy Interventional cardiology |
| dc.title.none.fl_str_mv | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p>Transcatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials that compared TAVR to sAVR for at least 2 years. The primary outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary outcomes were post-procedural and 2-year: effective orifice area (EOA), paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL). We identified 6 trials with a total of 7022 participants with severe aortic stenosis. TAVR was associated with 37% (95% CI [0.51–0.78) mean RR reduction of post-procedural PPM, a decrease that was not affected by the surgical risk at inclusion, neither by the transcatheter heart valve system. Postprocedural changes in gradient and EOA were also in favor of TAVR as there was a pooled mean difference decrease of 0.56 (95% CI [0.73–0.38]) in gradient and an increase of 0.47 (95% CI [0.38–0.56]) in EOA. Additionally, self-expandable valves were associated with a higher decrease in gradient than balloon ones (beta = 0.38; 95% CI [0.12–0.64]). However, TAVR was associated with a higher risk of moderate/severe PVL (pooled RR: 9.54, 95% CI [5.53–16.46]). All results were sustainable at 2 years.</p><h2>Other Information</h2> <p> Published in: Scientific Reports<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1038/s41598-021-91548-x" target="_blank">http://dx.doi.org/10.1038/s41598-021-91548-x</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_0fe801764b902ce5023b7e449be5ab55 |
| identifier_str_mv | 10.1038/s41598-021-91548-x |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/21598251 |
| publishDate | 2021 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysisCharbel Abi Khalil (14150028)Barbara Ignatiuk (14152983)Guliz Erdem (5874002)Hiam Chemaitelly (439114)Fabio Barilli (14152986)Mohamed El-Shazly (1502728)Jassim Al Suwaidi (284932)Samar Aboulsoud (14150022)Markus Kofler (5563250)Lukas Stastny (14152989)Hani Jneid (5038451)Nikolaos Bonaros (388592)Biomedical and clinical sciencesCardiovascular medicine and haematologyCardiac device therapyInterventional cardiology<p>Transcatheter aortic valve replacement (TAVR) has shown to reduce mortality compared to surgical aortic valve replacement (sAVR). However, it is unknown which procedure is associated with better post-procedural valvular function. We conducted a meta-analysis of randomized clinical trials that compared TAVR to sAVR for at least 2 years. The primary outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary outcomes were post-procedural and 2-year: effective orifice area (EOA), paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL). We identified 6 trials with a total of 7022 participants with severe aortic stenosis. TAVR was associated with 37% (95% CI [0.51–0.78) mean RR reduction of post-procedural PPM, a decrease that was not affected by the surgical risk at inclusion, neither by the transcatheter heart valve system. Postprocedural changes in gradient and EOA were also in favor of TAVR as there was a pooled mean difference decrease of 0.56 (95% CI [0.73–0.38]) in gradient and an increase of 0.47 (95% CI [0.38–0.56]) in EOA. Additionally, self-expandable valves were associated with a higher decrease in gradient than balloon ones (beta = 0.38; 95% CI [0.12–0.64]). However, TAVR was associated with a higher risk of moderate/severe PVL (pooled RR: 9.54, 95% CI [5.53–16.46]). All results were sustainable at 2 years.</p><h2>Other Information</h2> <p> Published in: Scientific Reports<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1038/s41598-021-91548-x" target="_blank">http://dx.doi.org/10.1038/s41598-021-91548-x</a></p>2021-06-07T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1038/s41598-021-91548-xhttps://figshare.com/articles/journal_contribution/Aortic_valve_function_post-replacement_of_severe_aortic_stenosis_by_transcatheter_procedure_versus_surgery_a_systematic_review_and_metanalysis/21598251CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215982512021-06-07T09:00:00Z |
| spellingShingle | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis Charbel Abi Khalil (14150028) Biomedical and clinical sciences Cardiovascular medicine and haematology Cardiac device therapy Interventional cardiology |
| status_str | publishedVersion |
| title | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| title_full | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| title_fullStr | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| title_full_unstemmed | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| title_short | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| title_sort | Aortic valve function post-replacement of severe aortic stenosis by transcatheter procedure versus surgery: a systematic review and metanalysis |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Cardiac device therapy Interventional cardiology |