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Meta-analysis of transcatheter aortic valve implantation for bicuspid versus tricuspid aortic valves.

Abstract：

BACKGROUND:We performed meta-analysis and meta-regression of transcatheter aortic valve implantation (TAVI) for the bicuspid aortic valve (B-AV) versus the tricuspid aortic valve (T-AV). METHODS:MEDLINE and EMBASE were searched through June 2018 using PubMed and OVID. We included comparative studies of TAVI patients with B-AV versus T-AV reporting at least one of postprocedural transcatheter valve regurgitation (TVR)/pacemaker implantation (PMI) incidence and early (30-day or in-hospital)/late (including early) mortality. For each study, crude (unadjusted) data regarding TVR/PMI incidence and early/late mortality in both the B-AV and T-AV groups were used to generate risk ratios (RRs). Study-specific estimates were combined in the random-effects model. Using meta-regression, we assessed potential confounders identified in preliminary meta-analysis. RESULTS:We identified 12 eligible studies including a total of 1045 B-AV and 4069 T-AV patients. Pooled analysis demonstrated an association of B-AV with a statistically significant increase in TVR incidence (RR, 1.42; p=0.006) but no statistically significant difference in PMI incidence (p=0.54) and 30-day (p=0.11)/midterm (1-year to 2-year) mortality (p=0.99) between patients with B-AV and those with T-AV. All meta-regression coefficients of 6 identified potential confounders (age, mean aortic valve gradient, aortic valve area, left ventricular ejection fraction, aortic calcification, and B-AV types) for the outcomes (TVR/PMI incidence and early/late mortality) were statistically non-significant. CONCLUSIONS:Postprocedural PMI incidence and 30-day/midterm (1-year to 2-year) mortality after TAVI may be similar between patients with B-AV and those with T-AV despite the significant association of B-AV with increased postprocedural TVR incidence.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Takagi H,Hari Y,Kawai N,Kuno T,Ando T,ALICE (All-Literature Investigation of Cardiovascular Evidence) Group.

doi

10.1016/j.jjcc.2019.03.018

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

40-48

issue

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(19)30098-X

journal_volume

pub_type

杂志文章,meta分析

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Meta-analysis of transcatheter aortic valve implantation for bicuspid versus tricuspid aortic valves.