Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients
<i>Background:</i> In recent years, trans-catheter aortic valve implantation (TAVI) has emerged as an excellent alternative to surgical aortic valve replacement (SAVR). Currently, there are several approved devices on the market, yet comparisons among them are scarce. We aimed to compare...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/18/5299 |
| _version_ | 1797486695400079360 |
|---|---|
| author | Ala Abu Dogosh Ahlam Adawi Aref El Nasasra Carlos Cafri Orit Barrett Gal Tsaban Rami Barashi Edward Koifman |
| author_facet | Ala Abu Dogosh Ahlam Adawi Aref El Nasasra Carlos Cafri Orit Barrett Gal Tsaban Rami Barashi Edward Koifman |
| author_sort | Ala Abu Dogosh |
| collection | DOAJ |
| description | <i>Background:</i> In recent years, trans-catheter aortic valve implantation (TAVI) has emerged as an excellent alternative to surgical aortic valve replacement (SAVR). Currently, there are several approved devices on the market, yet comparisons among them are scarce. We aimed to compare the various devices via a network meta-analysis. <i>Methods:</i> We performed a network meta-analysis including randomized controlled trials (RCTs) and propensity-matched studies that provide comparisons of either a single TAVI with SAVR or two different TAVI devices and report clinical outcomes. <i>Results:</i> We included 12 RCT and 13 propensity-matched studies comprising 42,105 patients, among whom 27,134 underwent TAVI using various valve systems (Sapien & Sapien XT, Sapien 3, Corvalve, Evolut & Evolut Pro, Acurate Neo, Portico). The mean follow-up time was 23.4 months. Sapien 3 was superior over SAVR in the reduction of all-cause mortality (OR = 0.53; 95%CrI 0.31–0.91), while no significant difference existed between other devices and SAVR. Aortic regurgitation was more frequent among TAVI devices compared to SAVR. There was no significant difference between the various THVs and SAVR in cardiovascular mortality, myocardial infarction, NYHA class III-IV, and endocarditis. <i>Conclusions:</i> Newer generation TAVI devices, especially Sapien 3 and Evolut R/Pro are associated with improved outcomes compared to SAVR and other devices of the older generation. |
| first_indexed | 2024-03-09T23:36:56Z |
| format | Article |
| id | doaj.art-58c78e931a9b411abe2e741c5b6073f9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:36:56Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-58c78e931a9b411abe2e741c5b6073f92023-11-23T16:58:23ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011118529910.3390/jcm11185299Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 PatientsAla Abu Dogosh0Ahlam Adawi1Aref El Nasasra2Carlos Cafri3Orit Barrett4Gal Tsaban5Rami Barashi6Edward Koifman7Soroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelSoroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelSoroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelSoroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelSoroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelSoroka Medical Center, Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101, IsraelMeir Medical Center, Tel Aviv University, Tel Aviv 6423906, IsraelMeir Medical Center, Tel Aviv University, Tel Aviv 6423906, Israel<i>Background:</i> In recent years, trans-catheter aortic valve implantation (TAVI) has emerged as an excellent alternative to surgical aortic valve replacement (SAVR). Currently, there are several approved devices on the market, yet comparisons among them are scarce. We aimed to compare the various devices via a network meta-analysis. <i>Methods:</i> We performed a network meta-analysis including randomized controlled trials (RCTs) and propensity-matched studies that provide comparisons of either a single TAVI with SAVR or two different TAVI devices and report clinical outcomes. <i>Results:</i> We included 12 RCT and 13 propensity-matched studies comprising 42,105 patients, among whom 27,134 underwent TAVI using various valve systems (Sapien & Sapien XT, Sapien 3, Corvalve, Evolut & Evolut Pro, Acurate Neo, Portico). The mean follow-up time was 23.4 months. Sapien 3 was superior over SAVR in the reduction of all-cause mortality (OR = 0.53; 95%CrI 0.31–0.91), while no significant difference existed between other devices and SAVR. Aortic regurgitation was more frequent among TAVI devices compared to SAVR. There was no significant difference between the various THVs and SAVR in cardiovascular mortality, myocardial infarction, NYHA class III-IV, and endocarditis. <i>Conclusions:</i> Newer generation TAVI devices, especially Sapien 3 and Evolut R/Pro are associated with improved outcomes compared to SAVR and other devices of the older generation.https://www.mdpi.com/2077-0383/11/18/5299aortic valve diseaseTAVIall-cause mortality |
| spellingShingle | Ala Abu Dogosh Ahlam Adawi Aref El Nasasra Carlos Cafri Orit Barrett Gal Tsaban Rami Barashi Edward Koifman Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients Journal of Clinical Medicine aortic valve disease TAVI all-cause mortality |
| title | Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients |
| title_full | Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients |
| title_fullStr | Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients |
| title_full_unstemmed | Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients |
| title_short | Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic Stenosis: A Network Meta-Analysis of 42,105 Patients |
| title_sort | comparison of transcatheter aortic valve implantation devices in aortic stenosis a network meta analysis of 42 105 patients |
| topic | aortic valve disease TAVI all-cause mortality |
| url | https://www.mdpi.com/2077-0383/11/18/5299 |
| work_keys_str_mv | AT alaabudogosh comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT ahlamadawi comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT arefelnasasra comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT carloscafri comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT oritbarrett comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT galtsaban comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT ramibarashi comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients AT edwardkoifman comparisonoftranscatheteraorticvalveimplantationdevicesinaorticstenosisanetworkmetaanalysisof42105patients |