Trends in Transcatheter Versus Surgical Aortic Valve Replacement Outcomes in Patients With Low-Surgical Risk: A Systematic Review and Meta-Analysis of Randomized Trials

被引：2

作者：

Kazemian, Sina ^{[1
,2
]}

Fallahtafti, Parisa ^{[2
,3
,4
]}

Sharifi, Mohammad ^{[2
]}

Mohammadi, Negin Sadat Hosseini ^{[1
,2
]}

Soleimani, Hamidreza ^{[1
,2
]}

Moghadam, Arman Soltani ^{[2
]}

Karimi, Elaheh ^{[2
,3
,4
]}

Sattar, Yaser ^{[5
]}

Jenab, Yaser ^{[1
,2
]}

Mehrani, Mehdi ^{[1
,2
]}

Hajizeinali, Alimohammad ^{[2
]}

Iskander, Mina ^{[6
]}

Sabet, Mehrshad Fathian ^{[7
]}

Salehi, Negar ^{[8
]}

Al-Azizi, Karim ^{[9
]}

Hakim, Diaa ^{[10
]}

Alam, Mahboob ^{[11
]}

Hosseini, Kaveh ^{[1
,2
]}

机构：

[1] Univ Tehran Med Sci, Cardiac Primary Prevent Res Ctr, Tehran, Iran

[2] Univ Tehran Med Sci, Tehran Heart Ctr, Tehran, Iran

[3] Univ Tehran Med Sci, Cardiovasc Dis Res Inst, Tehran, Iran

[4] Univ Tehran Med Sci, Sch Med, Tehran, Iran

[5] West Virginia Univ, Dept Cardiol, Morgantown, WV USA

[6] Med Coll Wisconsin, Dept Med Cardiol, Milwaukee, WI USA

[7] McLaren Flint Michigan State Univ, McLaren Flint, Flint, MI USA

[8] Akron Gen Hosp, Cleveland Clin, Heart Vasc & Thorac Inst, Akron, OH USA

[9] Baylor Scott & White Heart Hosp, Dept Cardiol, Plano, TX USA

[10] Harvard Med Sch, Brigham & Womens Hosp, Cardiovasc Div, Boston, MA USA

[11] Texas Heart Inst, Baylor Coll Med, Houston, TX USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2024年 / 13卷 / 21期

关键词：

aortic stenosis; low surgical risk; mortality; surgical aortic valve replacement; transcatheter aortic valve replacement; ONSET ATRIAL-FIBRILLATION; PACEMAKER IMPLANTATION;

D O I：

10.1161/JAHA.124.036179

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Limited data exist on long-term outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). This meta-analysis aims to elucidate outcome trends following TAVR versus SAVR in patients with severe aortic stenosis and low-surgical risk. Methods and Results: A systematic search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases from inception until May 2024, to identify studies comparing TAVR versus SAVR in patients with low-surgical risk (Society of Thoracic Surgeons predicted risk of mortality score <4%). The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular mortality, stroke, disabling stroke, rehospitalization, myocardial infarction, aortic valve reintervention, permanent pacemaker implantation, and new-onset atrial fibrillation. Binary random-effects models were used to compare the risk of each outcome across various follow-up intervals and the risk of bias was assessed using the Cochrane Collaboration's Risk of Bias-2 tool. The meta-analysis included 6 randomized trials including 4682 patients. TAVR was associated with a lower risk of all-cause mortality than SAVR in the 30-day (hazard ratio [HR: 0.45] [95% CI: 0.26-0.77], I-2: 0%) and 30-day to 1-year (HR: 0.55 [95% CI: 0.37-0.81], I-2: 16%) follow-ups. However, the risk of all-cause mortality was similar during >1-year follow-ups. TAVR was associated with a significantly lower risk of cardiovascular mortality, disabling stroke, rehospitalization, new-onset atrial fibrillation, and a higher risk of permanent pacemaker implantation compared with SAVR during the 30-day follow-up. Conclusions: TAVR was associated with a lower risk of all-cause mortality within the first year of post-procedural follow-up compared with SAVR. However, the risk of all-cause mortality was similar in >1-year follow-ups.

引用

页数：13

共 49 条

[1] Comparison of Balloon-Expandable vs Self-expandable Valves in Patients Undergoing Transcatheter Aortic Valve Replacement The CHOICE Randomized Clinical Trial [J].

Abdel-Wahab, Mohamed ;

Mehilli, Julinda ;

Frerker, Christian ;

Neumann, Franz-Josef ;

Kurz, Thomas ;

Toelg, Ralph ;

Zachow, Dirk ;

Guerra, Elena ;

Massberg, Steffen ;

Schaefer, Ulrich ;

El-Mawardy, Mohamed ;

Richardt, Gert .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2014, 311 (15) :1503-1514

[2] Bioprosthetic Valve Performance After Transcatheter Aortic Valve Replacement With Self-Expanding Versus Balloon-Expandable Valves in Large Versus Small Aortic Valve Annuli Insights From the CHOICE Trial and the CHOICE-Extend Registry [J].

Abdelghani, Mohammad ;

Mankerious, Nader ;

Allali, Abdelhakim ;

Landt, Martin ;

Kaur, Jatinderjit ;

Sulimov, Dmitriy S. ;

Merten, Constanze ;

Sachse, Susanne ;

Mehilli, Julinda ;

Neumann, Franz-Josef ;

Frerker, Christian ;

Kurz, Thomas ;

El-Mawardy, Mohamed ;

Richardt, Gert ;

Abdel-Wahab, Mohamed .

JACC-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (24) :2507-2518

[3] Aortic Angulation Attenuates Procedural Success Following Self-Expandable But Not Balloon-Expandable TAVR [J].

Abramowitz, Yigal ;

Maeno, Yoshio ;

Chakravarty, Tarun ;

Kazuno, Yoshio ;

Takahashi, Nobuyuki ;

Kawamori, Hiroyuki ;

Mangat, Geeteshwar ;

Cheng, Wen ;

Jilaihawi, Hasan ;

Makkar, Raj R. .

JACC-CARDIOVASCULAR IMAGING, 2016, 9 (08) :964-972

[4] Transcatheter Aortic-Valve Replacement with a Self-Expanding Prosthesis [J].

Adams, David H. ;

Popma, Jeffrey J. ;

Reardon, Michael J. ;

Yakubov, Steven J. ;

Coselli, Joseph S. ;

Deeb, G. Michael ;

Gleason, Thomas G. ;

Buchbinder, Maurice ;

Hermiller, James, Jr. ;

Kleiman, Neal S. ;

Chetcuti, Stan ;

Heiser, John ;

Merhi, William ;

Zorn, George ;

Tadros, Peter ;

Robinson, Newell ;

Petrossian, George ;

Hughes, G. Chad ;

Harrison, J. Kevin ;

Conte, John ;

Maini, Brijeshwar ;

Mumtaz, Mubashir ;

Chenoweth, Sharla ;

Oh, Jae K. .

NEW ENGLAND JOURNAL OF MEDICINE, 2014, 370 (19) :1790-1798

[5] Transcatheter versus surgical aortic valve replacement in lower-risk and higher-risk patients: a meta-analysis of randomized trials [J].

Ahmad, Yousif ;

Howard, James P. ;

Arnold, Ahran D. ;

Madhavan, Mahesh V. ;

Cook, Christopher M. ;

Alu, Maria ;

Mack, Michael J. ;

Reardon, Michael J. ;

Thourani, Vinod H. ;

Kapadia, Samir ;

Thyregod, Hans Gustav Horsted ;

Sondergaard, Lars ;

Jorgensen, Troels Hojsgaard ;

Toff, William D. ;

Van Mieghem, Nicolas M. ;

Makkar, Raj R. ;

Forrest, John K. ;

Leon, Martin B. .

EUROPEAN HEART JOURNAL, 2023, 44 (10) :836-852

[6] Conduction Disturbances After Transcatheter Aortic Valve Replacement Current Status and Future Perspectives [J].

Auffret, Vincent ;

Puri, Rishi ;

Urena, Marina ;

Chamandi, Chekrallah ;

Rodriguez-Gabella, Tania ;

Philippon, Francois ;

Rodes-Cabau, Josep .

CIRCULATION, 2017, 136 (11) :1049-+

[7] Early Outcomes of the Evolut R Transcatheter Aortic Valve A New Technology Between Achieved Goals and Desirable Improvements [J].

Barbanti, Marco .

JACC-CARDIOVASCULAR INTERVENTIONS, 2017, 10 (03) :283-285

[8] Early and latepace-makerimplantation after transcatheter and surgical aortic valve replacement [J].

Biancari, Fausto ;

Pykari, Jouni ;

Savontaus, Mikko ;

Laine, Mika ;

Husso, Annastiina ;

Virtanen, Marko ;

Maaranen, Pasi ;

Niemela, Matti ;

Makikallio, Timo ;

Tauriainen, Tuomas ;

Eskola, Markku ;

Raivio, Peter ;

Valtola, Antti ;

Juvonen, Tatu ;

Airaksinen, Juhani .

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2021, 97 (04) :E560-E568

[9] Transcatheter or Surgical Treatment of Aortic-Valve Stenosis [J].

Blankenberg, Stefan ;

Seiffert, Moritz ;

Vonthein, Reinhard ;

Baumgartner, Helmut ;

Bleiziffer, Sabine ;

Borger, Michael A. ;

Choi, Yeong-Hoon ;

Clemmensen, Peter ;

Cremer, Jochen ;

Czerny, Martin ;

Diercks, Nina ;

Eitel, Ingo ;

Ensminger, Stephan ;

Frank, Derk ;

Frey, Norbert ;

Hagendorff, Andreas ;

Hagl, Christian ;

Hamm, Christian ;

Kappert, Utz ;

Karck, Matthias ;

Kim, Won-Keun ;

Koenig, Inke R. ;

Krane, Markus ;

Landmesser, Ulf ;

Linke, Axel ;

Maier, Lars S. ;

Massberg, Steffen ;

Neumann, Franz-Josef ;

Reichenspurner, Hermann ;

Rudolph, Tanja K. ;

Schmid, Christof ;

Thiele, Holger ;

Twerenbold, Raphael ;

Walther, Thomas ;

Westermann, Dirk ;

Xhepa, Erion ;

Ziegler, Andreas ;

Falk, Volkmar .

NEW ENGLAND JOURNAL OF MEDICINE, 2024, 390 (17) :1572-1583

[10] Predictors of pacemaker implantation after transcatheter aortic valve implantation according to kind of prosthesis and risk profile: a systematic review and contemporary meta-analysis [J].

Bruno, Francesco ;

D'Ascenzo, Fabrizio ;

Vaira, Matteo Pio ;

Elia, Edoardo ;

Omede, Pierluigi ;

Kodali, Susheel ;

Barbanti, Marco ;

Rodes-Cabau, Josep ;

Husser, Oliver ;

Sossalla, Samuel ;

Van Mieghem, Nicolas M. ;

Bax, Jeroen ;

Hildick-Smith, David ;

Munoz-Garcia, Antonio ;

Pollari, Francesco ;

Fischlein, Theodor ;

Budano, Carlo ;

Montefusco, Antonio ;

Gallone, Guglielmo ;

De Filippo, Ovidio ;

Rinaldi, Mauro ;

la Torre, Michele ;

Salizzoni, Stefano ;

Atzeni, Francesco ;

Pocar, Marco ;

Conrotto, Federico ;

De Ferrari, Gaetano Maria .

EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, 2021, 7 (02) :143-153

← 1 2 3 4 5 →