학술논문
Comparative Outcomes of TAVR in Mixed Aortic Valve Disease and Aortic Stenosis: A Meta-analysis.
Document Type
Academic Journal
Author
Ugwu JK; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America. Email-ugwujustin@yahoo.com.; Kandah DR; Internal Medicine Residency, MercyOne Des Moines Medical Center, Des Moines, IA, United States of America.; Ndulue JK; Providence Medical Group, Chehalis Family Medicine, Chehalis, WA, United States of America.; Ebiem OP; Department of Hospital Medicine, Miami Valley Hospital, Dayton, OH, United States of America.; Ugwu-Erugo JN; Ebonyi State University Teaching Hospital, Abakaliki, Nigeria.; Hamilton R; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.; Osei K; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.; Taskesen T; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.; Shivapour DM; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.; Chawla A; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.; Marcus RH; Department of Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave, Des Moines, IA, 50314, United States of America.
Source
Publisher: Springer Healthcare Country of Publication: England NLM ID: 101634495 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2193-8261 (Print) Linking ISSN: 21936544 NLM ISO Abbreviation: Cardiol Ther Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2193-8261
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has become a suitable alternative to surgical aortic valve replacement (SAVR) for the treatment of symptomatic severe aortic stenosis (AS). A high proportion of patients with AS have mixed aortic valve disease (MAVD) with mild or more concurrent aortic regurgitation (AR). Differential outcomes of TAVR among patients with AS and MAVD have not been well characterized. We compared 1-year mortalities following TAVR among patients with MAVD and AS.
Methods: We conducted a meta-analysis of studies published in PubMed/Medline. The primary outcome was 1-year all-cause mortality following TAVR among patients with MAVD vs. AS. Secondary endpoints were: (1) incidence of AR within 30 days following TAVR (post TAVR AR); and (2) 1-year all-cause mortality within each group stratified according to severity of post TAVR AR.
Results: Nine studies involving 9505 participants were included in the analysis. At 1 year following TAVR, mortality was lower in MAVD than in AS; HR 0.89, 95% CI 0.81-0.98. The mortality advantage increased when pre-TAVR AR was moderate or more; HR 0.84, 95% CI 0.72-0.99. The mortality advantage was attenuated after correction for publication bias. There was a higher risk of post TAVR AR in the MAVD group; OR 1.51, 95% CI 1.20-1.90 but the impact on mortality of moderate vs. mild post TAVR AR was greater among patients with AS than in patients with MAVD HR 1.67 95% CI 0.89-3.14 vs. 0.93 95% CI 0.47-1.85.
Conclusions: Patients with MAVD have similar or improved survival 1 year after TAVR compared to those with AS.
(© 2022. The Author(s).)
Methods: We conducted a meta-analysis of studies published in PubMed/Medline. The primary outcome was 1-year all-cause mortality following TAVR among patients with MAVD vs. AS. Secondary endpoints were: (1) incidence of AR within 30 days following TAVR (post TAVR AR); and (2) 1-year all-cause mortality within each group stratified according to severity of post TAVR AR.
Results: Nine studies involving 9505 participants were included in the analysis. At 1 year following TAVR, mortality was lower in MAVD than in AS; HR 0.89, 95% CI 0.81-0.98. The mortality advantage increased when pre-TAVR AR was moderate or more; HR 0.84, 95% CI 0.72-0.99. The mortality advantage was attenuated after correction for publication bias. There was a higher risk of post TAVR AR in the MAVD group; OR 1.51, 95% CI 1.20-1.90 but the impact on mortality of moderate vs. mild post TAVR AR was greater among patients with AS than in patients with MAVD HR 1.67 95% CI 0.89-3.14 vs. 0.93 95% CI 0.47-1.85.
Conclusions: Patients with MAVD have similar or improved survival 1 year after TAVR compared to those with AS.
(© 2022. The Author(s).)