Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement : an updated systematic review and meta-analysis of RCTs. / Lerman, Tsahi T.; Levi, Amos; Jørgensen, Troels Højsgaard; Søndergaard, Lars; Talmor-Barkan, Yeela; Kornowski, Ran.
I: Frontiers in Cardiovascular Medicine, Bind 10, 1242608, 2023.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement
T2 - an updated systematic review and meta-analysis of RCTs
AU - Lerman, Tsahi T.
AU - Levi, Amos
AU - Jørgensen, Troels Højsgaard
AU - Søndergaard, Lars
AU - Talmor-Barkan, Yeela
AU - Kornowski, Ran
N1 - Publisher Copyright: 2023 Lerman, Levi, Jørgensen, Søndergaard, Talmor-Barkan and Kornowski.
PY - 2023
Y1 - 2023
N2 - Background: This study aims to compare valve durability between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Methods: We conducted a systematic review and meta-analysis using data from randomized controlled trials (RCTs). The primary outcome was structural valve deterioration (SVD). Secondary outcomes were bioprosthetic valve failure, reintervention, effective orifice area (EOA), mean pressure gradient, and moderate–severe aortic regurgitation (AR, transvalvular and/or paravalvular). Results: Twenty-five publications from seven RCTs consisting of 7,970 patients were included in the analysis with follow-up ranges of 2–8 years. No significant difference was found between the two groups with regard to SVD [odds ratio (OR) 0.72; 95% CI: 0.25–2.12]. The TAVI group was reported to exhibit a statistically significant higher risk of reintervention (OR 2.03; 95% CI: 1.34–3.05) and a moderate–severe AR (OR 6.54; 95% CI: 3.92–10.91) compared with the SAVR group. A trend toward lower mean pressure gradient in the TAVI group [(mean difference (MD) −1.61; 95% CI: −3.5 to 0.28)] and significant higher EOA (MD 0.20; 95% CI: 0.08–0.31) was noted. Conclusion: The present data indicate that TAVI provides a comparable risk of SVD with favorable hemodynamic profile compared with SAVR. However, the higher risk of significant AR and reintervention was demonstrated. Systematic Review Registration: PROSPERO (CRD42022363060).
AB - Background: This study aims to compare valve durability between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Methods: We conducted a systematic review and meta-analysis using data from randomized controlled trials (RCTs). The primary outcome was structural valve deterioration (SVD). Secondary outcomes were bioprosthetic valve failure, reintervention, effective orifice area (EOA), mean pressure gradient, and moderate–severe aortic regurgitation (AR, transvalvular and/or paravalvular). Results: Twenty-five publications from seven RCTs consisting of 7,970 patients were included in the analysis with follow-up ranges of 2–8 years. No significant difference was found between the two groups with regard to SVD [odds ratio (OR) 0.72; 95% CI: 0.25–2.12]. The TAVI group was reported to exhibit a statistically significant higher risk of reintervention (OR 2.03; 95% CI: 1.34–3.05) and a moderate–severe AR (OR 6.54; 95% CI: 3.92–10.91) compared with the SAVR group. A trend toward lower mean pressure gradient in the TAVI group [(mean difference (MD) −1.61; 95% CI: −3.5 to 0.28)] and significant higher EOA (MD 0.20; 95% CI: 0.08–0.31) was noted. Conclusion: The present data indicate that TAVI provides a comparable risk of SVD with favorable hemodynamic profile compared with SAVR. However, the higher risk of significant AR and reintervention was demonstrated. Systematic Review Registration: PROSPERO (CRD42022363060).
KW - bioprosthetic valve failure
KW - durability
KW - SAVR
KW - structural valve deterioration
KW - TAVI
U2 - 10.3389/fcvm.2023.1242608
DO - 10.3389/fcvm.2023.1242608
M3 - Review
C2 - 37771663
AN - SCOPUS:85172144089
VL - 10
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
SN - 2297-055X
M1 - 1242608
ER -
ID: 396755736