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Open Access 01-12-2024 | Transcatheter Aortic Valve Implantation | Research

Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients

Authors: Mohamed Hamouda Elkasaby, Basma Badrawy Khalefa, Mazen Negmeldin Aly Yassin, Yasmeen Jamal Alabdallat, Ahmed Atia, Obieda Altobaishat, Islam Omar, Amany Hussein

Published in: BMC Cardiovascular Disorders | Issue 1/2024

Abstract

Introduction

The published studies comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure aortic regurgitation (AR) are conflicting. We conducted this systematic review and meta-analysis to compare TAVI with SAVR in pure AR.

Methods

We searched PubMed, Embase, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) from inception until 23 June 2023. Review Manager was used for statistical analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes. Continuous outcomes were compared using the mean difference (MD) and 95% CI. The inconsistency test (I²) assessed the heterogeneity. We used the Newcastle-Ottawa scale to assess the quality of included studies. We evaluated the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale.

Results

We included six studies with 5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P = 0.63) (I² = 86%, P < 0.001). TAVI was favored over SAVR regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001) (I² = 11%, P = 0.34), in-hospital acute kidney injury (RR = 0.56; 95% CI: [0.41, 0.76], P < 0.001) (I² = 91%, P < 0.001), major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I² = 78%, P < 0.001), and shorter hospital say (MD = − 4.76 days; 95% CI: [− 5.27, − 4.25], P < 0.001) (I² = 88%, P < 0.001). In contrast, TAVI was associated with a higher rate of pacemaker implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I² = 0% P = 0.83).

Conclusion

TAVI reduces in-hospital stroke and is associated with better safety outcomes than SAVR in patients with pure AR.

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Title: Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients
Authors: Mohamed Hamouda Elkasaby
Basma Badrawy Khalefa
Mazen Negmeldin Aly Yassin
Yasmeen Jamal Alabdallat
Ahmed Atia
Obieda Altobaishat
Islam Omar
Amany Hussein
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Transcatheter Aortic Valve Implantation
Aortic Valve Replacement
Aortic Valve Replacement
Aortic Valve Replacement
Aortic Valve Stenosis
Stroke
Published in: BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-023-03667-0

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Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients

Abstract

Introduction

Methods

Results

Conclusion

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