Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs
BackgroundThis study aims to compare valve durability between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR).MethodsWe conducted a systematic review and meta-analysis using data from randomized controlled trials (RCTs). The primary outcome was structural...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1242608/full |
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| author | Tsahi T. Lerman Tsahi T. Lerman Tsahi T. Lerman Amos Levi Amos Levi Troels Højsgaard Jørgensen Lars Søndergaard Yeela Talmor-Barkan Yeela Talmor-Barkan Ran Kornowski Ran Kornowski |
| author_facet | Tsahi T. Lerman Tsahi T. Lerman Tsahi T. Lerman Amos Levi Amos Levi Troels Højsgaard Jørgensen Lars Søndergaard Yeela Talmor-Barkan Yeela Talmor-Barkan Ran Kornowski Ran Kornowski |
| author_sort | Tsahi T. Lerman |
| collection | DOAJ |
| description | BackgroundThis study aims to compare valve durability between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR).MethodsWe conducted a systematic review and meta-analysis using data from randomized controlled trials (RCTs). The primary outcome was structural valve deterioration (SVD). Secondary outcomes were bioprosthetic valve failure, reintervention, effective orifice area (EOA), mean pressure gradient, and moderate–severe aortic regurgitation (AR, transvalvular and/or paravalvular).ResultsTwenty-five publications from seven RCTs consisting of 7,970 patients were included in the analysis with follow-up ranges of 2–8 years. No significant difference was found between the two groups with regard to SVD [odds ratio (OR) 0.72; 95% CI: 0.25–2.12]. The TAVI group was reported to exhibit a statistically significant higher risk of reintervention (OR 2.03; 95% CI: 1.34–3.05) and a moderate–severe AR (OR 6.54; 95% CI: 3.92–10.91) compared with the SAVR group. A trend toward lower mean pressure gradient in the TAVI group [(mean difference (MD) −1.61; 95% CI: −3.5 to 0.28)] and significant higher EOA (MD 0.20; 95% CI: 0.08–0.31) was noted.ConclusionThe present data indicate that TAVI provides a comparable risk of SVD with favorable hemodynamic profile compared with SAVR. However, the higher risk of significant AR and reintervention was demonstrated.Systematic Review RegistrationPROSPERO (CRD42022363060). |
| first_indexed | 2024-03-12T01:15:02Z |
| format | Article |
| id | doaj.art-c0b4420c4a0a4ec28055175999a46548 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T01:15:02Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-c0b4420c4a0a4ec28055175999a465482023-09-13T14:00:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-09-011010.3389/fcvm.2023.12426081242608Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTsTsahi T. Lerman0Tsahi T. Lerman1Tsahi T. Lerman2Amos Levi3Amos Levi4Troels Højsgaard Jørgensen5Lars Søndergaard6Yeela Talmor-Barkan7Yeela Talmor-Barkan8Ran Kornowski9Ran Kornowski10Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tikva, IsraelDepartment of Cardiology, Rabin Medical Center, Petah Tikva, IsraelThe Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Cardiology, Rabin Medical Center, Petah Tikva, IsraelThe Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Cardiology, Rabin Medical Center, Petah Tikva, IsraelThe Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Cardiology, Rabin Medical Center, Petah Tikva, IsraelThe Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelBackgroundThis study aims to compare valve durability between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR).MethodsWe conducted a systematic review and meta-analysis using data from randomized controlled trials (RCTs). The primary outcome was structural valve deterioration (SVD). Secondary outcomes were bioprosthetic valve failure, reintervention, effective orifice area (EOA), mean pressure gradient, and moderate–severe aortic regurgitation (AR, transvalvular and/or paravalvular).ResultsTwenty-five publications from seven RCTs consisting of 7,970 patients were included in the analysis with follow-up ranges of 2–8 years. No significant difference was found between the two groups with regard to SVD [odds ratio (OR) 0.72; 95% CI: 0.25–2.12]. The TAVI group was reported to exhibit a statistically significant higher risk of reintervention (OR 2.03; 95% CI: 1.34–3.05) and a moderate–severe AR (OR 6.54; 95% CI: 3.92–10.91) compared with the SAVR group. A trend toward lower mean pressure gradient in the TAVI group [(mean difference (MD) −1.61; 95% CI: −3.5 to 0.28)] and significant higher EOA (MD 0.20; 95% CI: 0.08–0.31) was noted.ConclusionThe present data indicate that TAVI provides a comparable risk of SVD with favorable hemodynamic profile compared with SAVR. However, the higher risk of significant AR and reintervention was demonstrated.Systematic Review RegistrationPROSPERO (CRD42022363060).https://www.frontiersin.org/articles/10.3389/fcvm.2023.1242608/fullTAVISAVRdurabilitystructural valve deteriorationbioprosthetic valve failure |
| spellingShingle | Tsahi T. Lerman Tsahi T. Lerman Tsahi T. Lerman Amos Levi Amos Levi Troels Højsgaard Jørgensen Lars Søndergaard Yeela Talmor-Barkan Yeela Talmor-Barkan Ran Kornowski Ran Kornowski Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs Frontiers in Cardiovascular Medicine TAVI SAVR durability structural valve deterioration bioprosthetic valve failure |
| title | Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs |
| title_full | Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs |
| title_fullStr | Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs |
| title_full_unstemmed | Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs |
| title_short | Comparison of middle-term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement: an updated systematic review and meta-analysis of RCTs |
| title_sort | comparison of middle term valve durability between transcatheter aortic valve implantation and surgical aortic valve replacement an updated systematic review and meta analysis of rcts |
| topic | TAVI SAVR durability structural valve deterioration bioprosthetic valve failure |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1242608/full |
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