TY  - BOOK
AU  - Case, Brian
AU  - Doros, Gheorghe
AU  - Medranda, Giorgio
AU  - Rogers, Toby
AU  - Shults, Christian
AU  - Waksman, Ron
AU  - Yerasi, Charan
AU  - Zhang, Cheng
TI  - Transcatheter Aortic Valve Replacement in Low-Risk Bicuspid and Tricuspid Patients: Meta-Analysis
PY  - 2021///
KW  - *Aortic Valve Stenosis
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/su [Surgery]
KW  - Bayes Theorem
KW  - Humans
KW  - Prospective Studies
KW  - Risk
KW  - Risk Factors
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Advanced Cardiac Catheterization Research Fellowship
KW  - Interventional Cardiology Fellowship
KW  - Sleep Medicine Fellowship
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - 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
UR  - https://dx.doi.org/10.1016/j.carrev.2021.06.123
ER  -