Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis
BackgroundPreimplantation balloon aortic valvuloplasty (BAV) is considered a routine procedure during transcatheter aortic valve implantation (TAVI) to facilitate prosthesis implantation and expansion; however, it has been speculated that fewer embolic events and/or less hemodynamic instability may...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.115.003191 |
| _version_ | 1818289533086597120 |
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| author | Rodrigo Bagur Chun Shing Kwok Luis Nombela‐Franco Peter F. Ludman Mark A. de Belder Sandro Sponga Mark Gunning James Nolan Pantelis Diamantouros Patrick J. Teefy Bob Kiaii Michael W. A. Chu Mamas A. Mamas |
| author_facet | Rodrigo Bagur Chun Shing Kwok Luis Nombela‐Franco Peter F. Ludman Mark A. de Belder Sandro Sponga Mark Gunning James Nolan Pantelis Diamantouros Patrick J. Teefy Bob Kiaii Michael W. A. Chu Mamas A. Mamas |
| author_sort | Rodrigo Bagur |
| collection | DOAJ |
| description | BackgroundPreimplantation balloon aortic valvuloplasty (BAV) is considered a routine procedure during transcatheter aortic valve implantation (TAVI) to facilitate prosthesis implantation and expansion; however, it has been speculated that fewer embolic events and/or less hemodynamic instability may occur if TAVI is performed without preimplantation BAV. The aim of this study was to systematically review the clinical outcomes associated with TAVI undertaken without preimplantation BAV. Methods and ResultsWe conducted a search of Medline and Embase to identify studies that evaluated patients who underwent TAVI with or without preimplantation BAV for predilation. Pooled analysis and random‐effects meta‐analyses were used to estimate the rate and risk of adverse outcomes. Sixteen studies involving 1395 patients (674 with and 721 without preimplantation BAV) fulfilled the inclusion criteria. Crude device success was achieved in 94% (1311 of 1395), and 30‐day all‐cause mortality occurred in 6% (72 of 1282) of patients. Meta‐analyses evaluating outcomes of strategies with and without preimplantation BAV showed no statistically significant differences in terms of mortality (relative risk [RR] 0.61, 95% CI 0.32–1.14, P=0.12), safety composite end point (RR 0.85, 95% CI 0.62–1.18, P=0.34), moderate to severe paravalvular leaks (RR 0.68, 95% CI 0.23–1.99, P=0.48), need for postdilation (RR 0.86, 95% CI 0.66–1.13, P=0.58), stroke and/or transient ischemic attack (RR 0.72, 95% CI 0.30–1.71, P=0.45), and permanent pacemaker implantation (RR 0.80, 95% CI 0.49–1.30, P=0.37). ConclusionsOur analysis suggests that TAVI procedures with or without preimplantation BAV were associated with similar outcomes for a number of clinically relevant end points. Further studies including a large number of patients are needed to ascertain the impact of TAVI without preimplantation BAV as a standard practice. |
| first_indexed | 2024-12-13T02:13:47Z |
| format | Article |
| id | doaj.art-b0d96d517cfc46c7be45028a3da342dc |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:13:47Z |
| publishDate | 2016-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b0d96d517cfc46c7be45028a3da342dc2022-12-22T00:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-06-015610.1161/JAHA.115.003191Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐AnalysisRodrigo Bagur0Chun Shing Kwok1Luis Nombela‐Franco2Peter F. Ludman3Mark A. de Belder4Sandro Sponga5Mark Gunning6James Nolan7Pantelis Diamantouros8Patrick J. Teefy9Bob Kiaii10Michael W. A. Chu11Mamas A. Mamas12Division of Cardiology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, CanadaRoyal Stoke University Hospital, Stoke‐on‐Trent, Staffordshire, United KingdomDivision of Cardiology, Hospital Clínico San Carlos, Madrid, SpainQueen Elizabeth Hospital, Birmingham, United KingdomJames Cook University Hospital, Middlesbrough, North Yorkshire, United KingdomCardiothoracic Department, University Hospital of Udine, ItalyRoyal Stoke University Hospital, Stoke‐on‐Trent, Staffordshire, United KingdomRoyal Stoke University Hospital, Stoke‐on‐Trent, Staffordshire, United KingdomDivision of Cardiology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, CanadaDivision of Cardiology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, CanadaDepartment of Surgery, Western University, London, Ontario, CanadaDepartment of Surgery, Western University, London, Ontario, CanadaRoyal Stoke University Hospital, Stoke‐on‐Trent, Staffordshire, United KingdomBackgroundPreimplantation balloon aortic valvuloplasty (BAV) is considered a routine procedure during transcatheter aortic valve implantation (TAVI) to facilitate prosthesis implantation and expansion; however, it has been speculated that fewer embolic events and/or less hemodynamic instability may occur if TAVI is performed without preimplantation BAV. The aim of this study was to systematically review the clinical outcomes associated with TAVI undertaken without preimplantation BAV. Methods and ResultsWe conducted a search of Medline and Embase to identify studies that evaluated patients who underwent TAVI with or without preimplantation BAV for predilation. Pooled analysis and random‐effects meta‐analyses were used to estimate the rate and risk of adverse outcomes. Sixteen studies involving 1395 patients (674 with and 721 without preimplantation BAV) fulfilled the inclusion criteria. Crude device success was achieved in 94% (1311 of 1395), and 30‐day all‐cause mortality occurred in 6% (72 of 1282) of patients. Meta‐analyses evaluating outcomes of strategies with and without preimplantation BAV showed no statistically significant differences in terms of mortality (relative risk [RR] 0.61, 95% CI 0.32–1.14, P=0.12), safety composite end point (RR 0.85, 95% CI 0.62–1.18, P=0.34), moderate to severe paravalvular leaks (RR 0.68, 95% CI 0.23–1.99, P=0.48), need for postdilation (RR 0.86, 95% CI 0.66–1.13, P=0.58), stroke and/or transient ischemic attack (RR 0.72, 95% CI 0.30–1.71, P=0.45), and permanent pacemaker implantation (RR 0.80, 95% CI 0.49–1.30, P=0.37). ConclusionsOur analysis suggests that TAVI procedures with or without preimplantation BAV were associated with similar outcomes for a number of clinically relevant end points. Further studies including a large number of patients are needed to ascertain the impact of TAVI without preimplantation BAV as a standard practice.https://www.ahajournals.org/doi/10.1161/JAHA.115.003191aortic stenosisaortic valve replacementballoon aortic valvuloplastytranscutaneous aortic valve implantationtransfemoral aortic valve implantation |
| spellingShingle | Rodrigo Bagur Chun Shing Kwok Luis Nombela‐Franco Peter F. Ludman Mark A. de Belder Sandro Sponga Mark Gunning James Nolan Pantelis Diamantouros Patrick J. Teefy Bob Kiaii Michael W. A. Chu Mamas A. Mamas Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic stenosis aortic valve replacement balloon aortic valvuloplasty transcutaneous aortic valve implantation transfemoral aortic valve implantation |
| title | Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis |
| title_full | Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis |
| title_fullStr | Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis |
| title_short | Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta‐Analysis |
| title_sort | transcatheter aortic valve implantation with or without preimplantation balloon aortic valvuloplasty a systematic review and meta analysis |
| topic | aortic stenosis aortic valve replacement balloon aortic valvuloplasty transcutaneous aortic valve implantation transfemoral aortic valve implantation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.115.003191 |
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