Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature
The number of patients with severe aortic stenosis (AS) and a history of prior cardiac surgery has increased. Prior cardiac surgery increases the risk of adverse outcomes in patients undergoing aortic valve replacement. To evaluate the impact of prior cardiac surgery on clinical endpoints in patient...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-09-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/7/3/36 |
| _version_ | 1797554098381258752 |
|---|---|
| author | Azka Latif Noman Lateef Muhammad Junaid Ahsan Vikas Kapoor Rana Mohammad Usman Stephen Cooper Venkata Andukuri Mohsin Mirza Muhammad Zubair Ashfaq Rami Khouzam |
| author_facet | Azka Latif Noman Lateef Muhammad Junaid Ahsan Vikas Kapoor Rana Mohammad Usman Stephen Cooper Venkata Andukuri Mohsin Mirza Muhammad Zubair Ashfaq Rami Khouzam |
| author_sort | Azka Latif |
| collection | DOAJ |
| description | The number of patients with severe aortic stenosis (AS) and a history of prior cardiac surgery has increased. Prior cardiac surgery increases the risk of adverse outcomes in patients undergoing aortic valve replacement. To evaluate the impact of prior cardiac surgery on clinical endpoints in patients undergoing transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR), we performed a literature search using PubMed, Embase, Google Scholar, and Scopus databases. The clinical endpoints included in our study were 30-day mortality, 1–2-year mortality, acute kidney injury (AKI), bleeding, stroke, procedural time, and duration of hospital stay. Seven studies, which included a total of 8221 patients, were selected. Our study found that TAVR was associated with a lower incidence of stroke and bleeding complications. There was no significant difference in terms of AKI, 30-day all-cause mortality, and 1–2-year all-cause mortality between the two groups. The average procedure time and duration of hospital stay were 170 min less (<i>p</i> ≤ 0.01) and 3.6 days shorter (<i>p</i> < 0.01) in patients with TAVR, respectively. In patients with prior coronary artery bypass graft and severe AS, both TAVR and SAVR are reasonable options. However, TAVR may be associated with a lower incidence of complications like stroke and perioperative bleeding, in addition to a shorter length of stay. |
| first_indexed | 2024-03-10T16:26:56Z |
| format | Article |
| id | doaj.art-eab8c90e00c04724bce74e2615f076be |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T16:26:56Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-eab8c90e00c04724bce74e2615f076be2023-11-20T13:12:59ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252020-09-01733610.3390/jcdd7030036Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the LiteratureAzka Latif0Noman Lateef1Muhammad Junaid Ahsan2Vikas Kapoor3Rana Mohammad Usman4Stephen Cooper5Venkata Andukuri6Mohsin Mirza7Muhammad Zubair Ashfaq8Rami Khouzam9Department of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, University of Tennessee, Memphis, TN 38152, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Internal Medicine, Creighton University, Omaha, NE 68124, USADepartment of Cardiology, University of Tennessee, Memphis, TN 38152, USAThe number of patients with severe aortic stenosis (AS) and a history of prior cardiac surgery has increased. Prior cardiac surgery increases the risk of adverse outcomes in patients undergoing aortic valve replacement. To evaluate the impact of prior cardiac surgery on clinical endpoints in patients undergoing transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR), we performed a literature search using PubMed, Embase, Google Scholar, and Scopus databases. The clinical endpoints included in our study were 30-day mortality, 1–2-year mortality, acute kidney injury (AKI), bleeding, stroke, procedural time, and duration of hospital stay. Seven studies, which included a total of 8221 patients, were selected. Our study found that TAVR was associated with a lower incidence of stroke and bleeding complications. There was no significant difference in terms of AKI, 30-day all-cause mortality, and 1–2-year all-cause mortality between the two groups. The average procedure time and duration of hospital stay were 170 min less (<i>p</i> ≤ 0.01) and 3.6 days shorter (<i>p</i> < 0.01) in patients with TAVR, respectively. In patients with prior coronary artery bypass graft and severe AS, both TAVR and SAVR are reasonable options. However, TAVR may be associated with a lower incidence of complications like stroke and perioperative bleeding, in addition to a shorter length of stay.https://www.mdpi.com/2308-3425/7/3/36surgical aortic valve replacementtranscatheter aortic valve replacementTAVRSAVRprior CABGredo-AVR |
| spellingShingle | Azka Latif Noman Lateef Muhammad Junaid Ahsan Vikas Kapoor Rana Mohammad Usman Stephen Cooper Venkata Andukuri Mohsin Mirza Muhammad Zubair Ashfaq Rami Khouzam Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature Journal of Cardiovascular Development and Disease surgical aortic valve replacement transcatheter aortic valve replacement TAVR SAVR prior CABG redo-AVR |
| title | Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature |
| title_full | Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature |
| title_fullStr | Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature |
| title_full_unstemmed | Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature |
| title_short | Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature |
| title_sort | transcatheter versus surgical aortic valve replacement in patients with cardiac surgery meta analysis and systematic review of the literature |
| topic | surgical aortic valve replacement transcatheter aortic valve replacement TAVR SAVR prior CABG redo-AVR |
| url | https://www.mdpi.com/2308-3425/7/3/36 |
| work_keys_str_mv | AT azkalatif transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT nomanlateef transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT muhammadjunaidahsan transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT vikaskapoor transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT ranamohammadusman transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT stephencooper transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT venkataandukuri transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT mohsinmirza transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT muhammadzubairashfaq transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature AT ramikhouzam transcatheterversussurgicalaorticvalvereplacementinpatientswithcardiacsurgerymetaanalysisandsystematicreviewoftheliterature |