Kuljit Singh1,2,3, Ajit S Bhalla4, Mohammad A Qutub5, Kristin Carson3, Marino Labinaz6. 1. Department of Cardiology, Gold Coast University Hospital, 1 Hospital Blvd Southport, QLD 4215, Australia. 2. Griffith University, 58 Parklands Drive Gold Coast, QLD 4215, Australia. 3. University of Adelaide, North Terrace Adelaide, South Australia 5000, Australia. 4. University of Sydney, Sydney NSW 2006, Australia. 5. Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. 6. University of Ottawa Heart Institute, 40 Ruskin St Ottawa, Ontario, Canada K1Y 4W7.
Abstract
Aims: Recent studies have reported non-inferior outcomes for transcatheter aortic valve implantation (TAVI) compared with surgical aortic valve replacement (SAVR) in intermediate-risk patients. However, a comparison of outcomes among TAVI patients depending upon the surgical risk score has not been performed in a large study. Our aim was to compare the outcomes of TAVI in low-, intermediate-, and high-risk patients, to ascertain if the morbidity and mortality is related to the patient's risk profile or the procedure itself. Methods and results: A thorough computer-based search was performed using Ovid MEDLINE, EMBASE, Google Scholar, and PubMed databases. We included original research studies reporting data on TAVI in the low-, intermediate-, and high-risk groups. Patients in intermediate-risk group were compared to the high-risk cohort for device success, mortality, and complications. A total of 2414 patients in the intermediate-risk group were compared with 1597 high-risk patients. On meta-analysis, intermediate-risk group demonstrated similar device success [odds ratio (OR) 1.29, 95% confidence interval (CI) 0.87-1.90, I2 = 0%, P = 0.2) but a lower 30-day mortality OR 0.54, 95% CI 0.34-0.86, I2 = 49%, P = 0.009). There was no difference in the incidence of stroke (OR 1.17, 95% CI 0.80-1.71, I2 = 36%, P = 0.42) or permanent pacemaker implantation between the two groups (OR 1.04, 95% CI 0.82-1.32, I2 = 41%, P = 0.74). Conclusion: Transcatheter aortic valve implantation in intermediate-risk patients carries a low mortality and high success. Incidence of pacemaker and stroke remains high in the lower risk group. Published on behalf of the European Society of Cardiology. All rights reserved.
Aims: Recent studies have reported non-inferior outcomes for transcatheter aortic valve implantation (TAVI) compared with surgical aortic valve replacement (SAVR) in intermediate-risk patients. However, a comparison of outcomes among TAVI patients depending upon the surgical risk score has not been performed in a large study. Our aim was to compare the outcomes of TAVI in low-, intermediate-, and high-risk patients, to ascertain if the morbidity and mortality is related to the patient's risk profile or the procedure itself. Methods and results: A thorough computer-based search was performed using Ovid MEDLINE, EMBASE, Google Scholar, and PubMed databases. We included original research studies reporting data on TAVI in the low-, intermediate-, and high-risk groups. Patients in intermediate-risk group were compared to the high-risk cohort for device success, mortality, and complications. A total of 2414 patients in the intermediate-risk group were compared with 1597 high-risk patients. On meta-analysis, intermediate-risk group demonstrated similar device success [odds ratio (OR) 1.29, 95% confidence interval (CI) 0.87-1.90, I2 = 0%, P = 0.2) but a lower 30-day mortality OR 0.54, 95% CI 0.34-0.86, I2 = 49%, P = 0.009). There was no difference in the incidence of stroke (OR 1.17, 95% CI 0.80-1.71, I2 = 36%, P = 0.42) or permanent pacemaker implantation between the two groups (OR 1.04, 95% CI 0.82-1.32, I2 = 41%, P = 0.74). Conclusion: Transcatheter aortic valve implantation in intermediate-risk patients carries a low mortality and high success. Incidence of pacemaker and stroke remains high in the lower risk group. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Hyeok Sang Woo; Ho Young Hwang; Ho Jin Kim; Joon Bum Kim; Sak Lee; Cheong Lim; Byung-Cheul Chang; Na Rae Lee; Youshin Suh; Jae Woong Choi Journal: J Chest Surg Date: 2021-10-05
Authors: Jo M Zelis; Pim A L Tonino; Nico H J Pijls; Bernard De Bruyne; Richard L Kirkeeide; K Lance Gould; Nils P Johnson Journal: J Interv Cardiol Date: 2020-07-22 Impact factor: 2.279