In:
Clinical Cardiology, Wiley, Vol. 41, No. 7 ( 2018-07), p. 896-902
Abstract:
Transcatheter aortic valve replacement (TAVR) has become an alternative treatment to surgery in patients with severe aortic stenosis. However, patients with bicuspid aortic stenosis (BAV) are usually excluded from major TAVR studies. The aim of this study is to reexamine current evidence of TAVR in patients with severe aortic stenosis and BAV compared with tricuspid aortic valve (TAV). Hypothesis There might be differences in outcomes post TAVR between patients with BAV comparing to TAV. Method Databases were systematically searched for relevant articles featuring cohort studies that included patients with BAV and TAV who underwent TAVR studies, of which reported outcomes of interest included mortality and complications in both groups. Pooled effect size was calculated with a random‐effect model and weighted for the inverse of variance, to compare outcomes post‐TAVR between BAV and TAV. Results Nine studies were included in the meta‐analysis. There was no difference in 30‐day mortality rate in patients with BAV compared with TAV (OR: 1.27, 95% CI: 0.84–1.93, I 2 = 0). Patients with BAV were more likely to have a moderate to severe paravalvular leak (9 studies; OR: 1.42, 95% CI: 1.08–1.87, I 2 = 0) and conversion to surgery (5 studies; OR: 5.48, 95% CI: 1.74–17.27, I 2 = 0), and less likely to have device success compared with patients with TAV (5 studies; OR: 0.57, 95% CI: 0.40–0.81, I 2 = 0%). Conclusions There was no difference in mortality post‐TAVR in patients with BAV compared with TAV. Further randomized studies should be done in newer‐generation prostheses to assess this association.
Type of Medium:
Online Resource
ISSN:
0160-9289
,
1932-8737
DOI:
10.1002/clc.2018.41.issue-7
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2048223-1
