Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients
Abstract Introduction The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR. Methods We...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03667-0 |
| _version_ | 1797340363100258304 |
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| author | Mohamed Hamouda Elkasaby Basma Badrawy Khalefa Mazen Negmeldin Aly Yassin Yasmeen Jamal Alabdallat Ahmed Atia Obieda Altobaishat Islam Omar Amany Hussein |
| author_facet | Mohamed Hamouda Elkasaby Basma Badrawy Khalefa Mazen Negmeldin Aly Yassin Yasmeen Jamal Alabdallat Ahmed Atia Obieda Altobaishat Islam Omar Amany Hussein |
| author_sort | Mohamed Hamouda Elkasaby |
| collection | DOAJ |
| description | Abstract Introduction The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR. Methods We searched PubMed, Embase, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) from inception until 23 June 2023. Review Manager was used for statistical analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes. Continuous outcomes were compared using the mean difference (MD) and 95% CI. The inconsistency test (I2) assessed the heterogeneity. We used the Newcastle-Ottawa scale to assess the quality of included studies. We evaluated the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Results We included six studies with 5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P = 0.63) (I2 = 86%, P < 0.001). TAVI was favored over SAVR regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001) (I2 = 11%, P = 0.34), in-hospital acute kidney injury (RR = 0.56; 95% CI: [0.41, 0.76], P < 0.001) (I 2 = 91%, P < 0.001), major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I 2 = 78%, P < 0.001), and shorter hospital say (MD = − 4.76 days; 95% CI: [− 5.27, − 4.25], P < 0.001) (I 2 = 88%, P < 0.001). In contrast, TAVI was associated with a higher rate of pacemaker implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I 2 = 0% P = 0.83). Conclusion TAVI reduces in-hospital stroke and is associated with better safety outcomes than SAVR in patients with pure AR. |
| first_indexed | 2024-03-08T10:01:02Z |
| format | Article |
| id | doaj.art-a23d6022ff234cd190a813d944b8eceb |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-08T10:01:02Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-a23d6022ff234cd190a813d944b8eceb2024-01-29T10:56:04ZengBMCBMC Cardiovascular Disorders1471-22612024-01-0124111610.1186/s12872-023-03667-0Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patientsMohamed Hamouda Elkasaby0Basma Badrawy Khalefa1Mazen Negmeldin Aly Yassin2Yasmeen Jamal Alabdallat3Ahmed Atia4Obieda Altobaishat5Islam Omar6Amany Hussein7Faculty of Medicine, Al-Azhar UniversityFaculty of Medicine, Ain Shams UniversityFaculty of Medicine, Helwan UniversityFaculty of Medicine, Hashemite UniversityFaculty of Medicine, Cairo UniversityFaculty of Medicine, Jordan University of Science and TechnologyFaculty of Pharmacy, South Valley UniversityFaculty of Medicine, Al-Azhar UniversityAbstract Introduction The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR. Methods We searched PubMed, Embase, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) from inception until 23 June 2023. Review Manager was used for statistical analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes. Continuous outcomes were compared using the mean difference (MD) and 95% CI. The inconsistency test (I2) assessed the heterogeneity. We used the Newcastle-Ottawa scale to assess the quality of included studies. We evaluated the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Results We included six studies with 5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P = 0.63) (I2 = 86%, P < 0.001). TAVI was favored over SAVR regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001) (I2 = 11%, P = 0.34), in-hospital acute kidney injury (RR = 0.56; 95% CI: [0.41, 0.76], P < 0.001) (I 2 = 91%, P < 0.001), major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I 2 = 78%, P < 0.001), and shorter hospital say (MD = − 4.76 days; 95% CI: [− 5.27, − 4.25], P < 0.001) (I 2 = 88%, P < 0.001). In contrast, TAVI was associated with a higher rate of pacemaker implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I 2 = 0% P = 0.83). Conclusion TAVI reduces in-hospital stroke and is associated with better safety outcomes than SAVR in patients with pure AR.https://doi.org/10.1186/s12872-023-03667-0Aortic regurgitationTranscatheter aortic valve implantationSurgical aortic valve replacement |
| spellingShingle | Mohamed Hamouda Elkasaby Basma Badrawy Khalefa Mazen Negmeldin Aly Yassin Yasmeen Jamal Alabdallat Ahmed Atia Obieda Altobaishat Islam Omar Amany Hussein Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients BMC Cardiovascular Disorders Aortic regurgitation Transcatheter aortic valve implantation Surgical aortic valve replacement |
| title | Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients |
| title_full | Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients |
| title_fullStr | Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients |
| title_full_unstemmed | Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients |
| title_short | Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients |
| title_sort | transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation a systematic review and meta analysis of 33 484 patients |
| topic | Aortic regurgitation Transcatheter aortic valve implantation Surgical aortic valve replacement |
| url | https://doi.org/10.1186/s12872-023-03667-0 |
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