Valve in valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-Surgical aortic valve replacement (redo-SAVR): A systematic review and meta-analysis

Autor:	Varun Kumar, Sushruth Edla, Jonathan Spagnola, Chad Kliger, James Lafferty, Frank Tamburrino, Deepak Asti, Amrutha Paturu, Gregory Maniatis, Abdullah B. Munir, Praveen Vemula, Sriramya Gayam, Emad A. Barsoum, Nikhil Nalluri, Varunsiri Atti, Boutros Karam, Ruben Kandov, Nileshkumar J. Patel
Rok vydání:	2018
Předmět:	Aortic valve medicine.medical_specialty Transcatheter aortic 030204 cardiovascular system & hematology Lower risk Prosthesis Design Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Postoperative Complications Aortic valve replacement medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Stroke Heart Valve Prosthesis Implantation business.industry Gold standard Aortic Valve Stenosis medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Meta-analysis Aortic valve stenosis Aortic Valve Cardiology and Cardiovascular Medicine business
Zdroj:	Journal of interventional cardiology. 31(5)
ISSN:	1540-8183
Popis:	Background Bioprosthetic (BP) valves have been increasingly used for aortic valve replacement over the last decade. Due to their limited durability, patients presenting with failed BP valves are rising. Valve in Valve - Transcatheter Aortic Valve Implantation (ViV-TAVI) emerged as an alternative to the gold standard redo-Surgical Aortic Valve Replacement (redo-SAVR). However, the utility of ViV-TAVI is poorly understood. Methods A systematic electronic search of the scientific literature was done in PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov. Only studies which compared the safety and efficacy of ViV-TAVI and redo-SAVR head to head in failed BP valves were included. Results Six observational studies were eligible and included 594 patients, of whom 255 underwent ViV- TAVI and 339 underwent redo-SAVR. There was no significant difference between ViV-TAVI and redo- SAVR for procedural, 30 day and 1 year mortality rates. ViV-TAVI was associated with lower risk of permanent pacemaker implantation (PPI) (OR: 0.43, CI: 0.21-0.89; P = 0.02) and a trend toward increased risk of paravalvular leak (PVL) (OR: 5.45, CI: 0.94-31.58; P = 0.06). There was no significant difference for stroke, major bleeding, vascular complications and postprocedural aortic valvular gradients more than 20 mm-hg. Conclusion Our results reiterate the safety and feasibility of ViV-TAVI for failed aortic BP valves in patients deemed to be at high risk for surgery. VIV-TAVI was associated with lower risk of permanent pacemaker implantation with a trend toward increased risk of paravalvular leak.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a16839a5d38c2e245bec253c82342b4 https://pubmed.ncbi.nlm.nih.gov/29781182 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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