PMID- 34788825
OWN - NLM
STAT- MEDLINE
DCOM- 20220330
LR  - 20220401
IS  - 2058-1742 (Electronic)
IS  - 2058-1742 (Linking)
VI  - 8
IP  - 2
DP  - 2022 Mar 2
TI  - Transcatheter aortic valve replacement in mixed aortic valve disease: a 
      systematic review and meta-analysis.
PG  - 169-176
LID - 10.1093/ehjqcco/qcab080 [doi]
AB  - BACKGROUND: Utilization of transcatheter aortic valve replacement (TAVR) has 
      expanded from high-risk patients to intermediate- and select low-risk candidates 
      with severe aortic stenosis (AS). TAVR is currently not indicated for patients 
      with aortic insufficiency, and its outcomes in mixed aortic valve disease (MAVD) 
      are unclear. METHODS: A systematic search of PubMed, Medline, CINHAL, and 
      Cochrane databases was performed to identify studies comparing TAVR outcomes in 
      patients with AS vs. MAVD. Primary outcomes included 30-day and late all-cause 
      mortality, and paravalvular regurgitation (PVR). Secondary outcomes were major 
      bleeding, vascular complications, device implantation success, permanent 
      pacemaker, and stroke. Pooled odds ratios (OR) and 95% confidence intervals (CIs) 
      were calculated using Der Simonian-Laird random-effects model. RESULTS: Six 
      observational studies with 58 879 patients were included in the analysis. There 
      was no significant difference in 30-day all-cause mortality [OR 1.03 (95% CI 
      0.92-1.15); P = 0.63], however, MAVD group had higher odds of moderate-to-severe 
      PVR [1.81 (1.41-2.31); P < 0.01]. MAVD patients had lower odds of device 
      implantation success [0.60 (0.40-0.91); P = 0.02] while other secondary outcomes 
      were similar in the two groups. CONCLUSIONS: TAVR in MAVD is associated with 
      increased odds of paravalvular regurgitation and lower odds of device 
      implantation success when compared to severe aortic stenosis.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Guddeti, Raviteja R
AU  - Guddeti RR
AD  - Division of Cardiovascular Diseases, Creighton University School of Medicine, 
      Omaha, NE 68154, USA.
AD  - Division of Cardiovascular Diseases, Minneapolis Heart Institute, Minneapolis, MN 
      55407, USA.
FAU - Gill, Gauravpal S
AU  - Gill GS
AUID- ORCID: 0000-0002-4806-6418
AD  - Division of Cardiovascular Diseases, Creighton University School of Medicine, 
      Omaha, NE 68154, USA.
FAU - Garcia-Garcia, Hector M
AU  - Garcia-Garcia HM
AD  - Department of Medicine, Georgetown University, Washington, DC 20057, USA.
AD  - Division of Cardiovascular Medicine, MedStar Washington Hospital Center, 
      Washington, DC 20010, USA.
FAU - Alla, Venkata Mahesh
AU  - Alla VM
AD  - Division of Cardiovascular Diseases, Creighton University School of Medicine, 
      Omaha, NE 68154, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - England
TA  - Eur Heart J Qual Care Clin Outcomes
JT  - European heart journal. Quality of care & clinical outcomes
JID - 101677796
SB  - IM
MH  - Aortic Valve/surgery
MH  - *Aortic Valve Stenosis/surgery
MH  - Humans
MH  - Risk Factors
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aortic stenosis
OT  - Mixed aortic valve disease
OT  - Transcatheter aortic valve replacement
EDAT- 2021/11/18 06:00
MHDA- 2022/03/31 06:00
CRDT- 2021/11/17 20:17
PHST- 2021/08/06 00:00 [received]
PHST- 2021/10/26 00:00 [revised]
PHST- 2021/11/08 00:00 [accepted]
PHST- 2021/11/18 06:00 [pubmed]
PHST- 2022/03/31 06:00 [medline]
PHST- 2021/11/17 20:17 [entrez]
AID - 6426177 [pii]
AID - 10.1093/ehjqcco/qcab080 [doi]
PST - ppublish
SO  - Eur Heart J Qual Care Clin Outcomes. 2022 Mar 2;8(2):169-176. doi: 
      10.1093/ehjqcco/qcab080.