04141nam a22006857a 4500
210726s20212021 xxu||||| |||| 00| 0 eng d
10.1016/j.carrev.2021.06.123 [doi]
S1553-8389(21)00488-7 [pii]
Ovid MEDLINE(R)
34253474
Transcatheter Aortic Valve Replacement in Low-Risk Bicuspid and Tricuspid Patients: Meta-Analysis.
Cardiovascular Revascularization Medicine. 33:1-6, 2021 12.
Cardiovasc Revasc Med. 33:1-6, 2021 12.
Cardiovasc Revasc Med. 2021 Jun 25
Cardiovascular revascularization medicine : including molecular interventions
2021
FY2022
2021 Jun 25
aheadofprint
ppublish
2021-07-26
Cardiovascular Revascularization Medicine. 2021 Jun 25
FY2021
Available in print through MWHC library: 2002 - present
BACKGROUND: Most pivotal transcatheter aortic valve replacement (TAVR) trials have excluded patients with bicuspid aortic stenosis (AS). This study compared TAVR in low-risk patients with bicuspid AS to those with tricuspid AS, incorporating data from prospective trials.
CONCLUSIONS: Preliminary data from the FDA-approved IDE trials of low-risk patients with bicuspid AS undergoing TAVR demonstrated 30-day outcomes comparable to low-risk tricuspid patients, except for a trend toward higher stroke in bicuspid patients. Randomized trials are warranted to reassure the safety and long-term outcome of TAVR in patients with severe bicuspid AS. Copyright (c) 2021. Published by Elsevier Inc.
METHODS: We selected prospective US low-risk TAVR trials containing a bicuspid arm for this meta-analysis, examining outcomes at 30 days. Study results were pooled using a hierarchical Bayesian random-effects model.
RESULTS: Included were 3 Food and Drug Administration (FDA)-approved investigational device exemption (IDE) trials that enrolled a total of 1810 low-risk patients with symptomatic severe AS for TAVR. We compared 380 bicuspid patients with 1430 tricuspid patients. Event rates at 30 days overall were low, with similar mortality (odds ratio [OR], 0.38; 95% credible interval [CrI]: 0.08, 1.78; I2, 0%), non-disabling stroke (OR, 0.45; 95% CrI: 0.15, 1.07; I2, 9%), and permanent pacemaker implantation (OR, 0.86; 95% CrI: 0.41, 1.47; I2, 59%). There were statistically significant differences in disabling stroke (OR, 0.16; 95% CrI: 0.01, 0.90; I2, NA) and coronary obstruction (OR, 0.21; 95% CrI: 0.05, 0.91) that disappeared after sensitivity analysis by adding a single event to the tricuspid arm. Hemodynamics were similar at 30 days.
English
*Aortic Valve Stenosis
*Transcatheter Aortic Valve Replacement
Aortic Valve Stenosis/dg [Diagnostic Imaging]
Aortic Valve Stenosis/su [Surgery]
Aortic Valve/dg [Diagnostic Imaging]
Aortic Valve/su [Surgery]
Bayes Theorem
Humans
Prospective Studies
Risk
Risk Factors
Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
Treatment Outcome
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Advanced Cardiac Catheterization Research Fellowship
Interventional Cardiology Fellowship
Sleep Medicine Fellowship
Journal Article
Case, Brian
Doros, Gheorghe
Medranda, Giorgio
Rogers, Toby
Shults, Christian
Waksman, Ron
Yerasi, Charan
Zhang, Cheng
Case BC, Doros G, Medranda GA, Rogers T, Shults CC, Waksman R, Yerasi C, Zhang C
https://dx.doi.org/10.1016/j.carrev.2021.06.123
https://dx.doi.org/10.1016/j.carrev.2021.06.123
ART
Article
0
0
0
0
Article
authcat
authcat
2021-07-26
0
34253474
34253474
2021-07-26
2021-07-26
ART
6668
6668