Clinical Outcomes of Transcatheter Aortic Valve Replacement in Nonagenarians: A Systematic Review and Meta-Analysis
| Autor: | Deguang Wang, Jinglin Zhang, Mingjie Fu, Wei Liu, Yu Du, Yan Liu, Yujie Zhou, Yingxin Zhao, Yue Ma |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty medicine.medical_treatment Review Article 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences Postoperative Complications 0302 clinical medicine Valve replacement Aortic valve replacement medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Myocardial infarction Heart valve Mortality Stroke Aged 80 and over business.industry Acute kidney injury Aortic Valve Stenosis medicine.disease Surgery Stenosis Treatment Outcome medicine.anatomical_structure lcsh:RC666-701 Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Interventional Cardiology Journal of Interventional Cardiology, Vol 2019 (2019) |
| ISSN: | 1540-8183 0896-4327 |
| Popis: | Objectives. To compare the incidence of mortality and complications between nonagenarians and younger patients undergoing transcatheter aortic valve replacement (TAVR). Background. TAVR has become an alternative treatment for nonagenarian patients with severe aortic stenosis. Previous studies have reported conflicting results regarding the clinical outcomes between nonagenarians and younger patients who underwent TAVR. Methods. We searched PubMed, EMBASE, and Cochrane Library databases with predefined criteria from the inception dates to July 8, 2018. The primary clinical endpoint was 30-day and 1-year all-cause mortalities. Secondary outcomes were considered the rates of stroke, myocardial infarction, any bleeding, any acute kidney injury, any vascular complications, new pacemaker implantation, and conversion to surgical aortic valve replacement. Results. A total of 5 eligible studies with 25,371 patients were included in this meta-analysis. Compared with younger patients who underwent TAVR, nonagenarians had a significantly higher mean Society of Thoracic Surgeons score (STS score) (MD, 2.80; 95%CI: 2.58, 3.30; P Conclusions. Nonagenarians showed worse clinical outcomes than younger patients after TAVR, while the incidence of mortality was acceptable. TAVR remains an option for nonagenarian patients with severe aortic stenosis and should be comprehensively evaluated by the heart valve team. |
| Databáze: | OpenAIRE |
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