Outcomes of Transcatheter Aortic Valve Replacement Using Third-Generation Balloon-Expandable Versus Self-Expanding Valves: A Meta-analysis.

Content Provider	Europe PMC
Author	Siddiqui, Saman Asad Kazemian, Sina Gupta, Tanush Patel, Nilay K. Sakhuja, Rahul Inglessis, Ignacio Jassar, Arminder Langer, Nathaniel Passeri, Jonathan J. Dauerman, Harold L. Elmariah, Sammy Kolte, Dhaval
Copyright Year	2024
Abstract	BackgroundThe choice of transcatheter aortic valve replacement (TAVR) prosthesis is crucial in optimizing short- and long-term outcomes. The objective of this study was to conduct a meta-analysis comparing outcomes of third-generation balloon-expandable valves (BEV) vs self-expanding valves (SEV).MethodsElectronic databases were searched from inception to June 2023 for studies comparing third-generation BEV vs SEV. Primary outcome was all-cause mortality. Secondary outcomes included clinical and hemodynamic end points. Random-effects models were used to calculate pooled odds ratios (ORs) or weighted mean differences (WMDs).ResultsThe meta-analysis included 16 studies and 10,174 patients (BEV, 5753 and SEV, 4421). There were no significant differences in 1-year all-cause mortality (OR, 1.15; 95% CI, 0.89-1.48) between third-generation BEV vs SEV. TAVR with third generation BEV was associated with a significantly lower risk of TIA/stroke (OR, 0.62; 95% CI, 0.44-0.87), permanent pacemaker implantation (OR, 0.55; 95% CI, 0.44-0.70), and ≥moderate paravalvular leak (PVL, OR, 0.43; 95% CI, 0.25-0.75), and higher risk of ≥moderate patient-prosthesis mismatch (OR, 3.76; 95% CI, 2.33-6.05), higher mean gradient (WMD, 4.35; 95% CI, 3.63-5.08), and smaller effective orifice area (WMD, −0.30; 95% CI, −0.37 to −0.23), compared with SEV.ConclusionIn this meta-analysis, TAVR with third-generation BEV vs SEV was associated with similar all-cause mortality, lower risk of TIA/stroke, permanent pacemaker implantation, and ≥moderate PVL, but higher risk of ≥moderate patient-prosthesis mismatch, higher mean gradient, and smaller effective orifice area. Large, adequately powered randomized trials are needed to evaluate long-term outcomes of TAVR with latest generations of BEV vs SEV.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC11308705&blobtype=pdf
Volume Number	3
DOI	10.1016/j.jscai.2024.102146
PubMed Central reference number	PMC11308705
Issue Number	7
PubMed reference number	39131997
Journal	Journal of the Society for Cardiovascular Angiography & Interventions [J Soc Cardiovasc Angiogr Interv]
e-ISSN	27729303
Language	English
Publisher	Elsevier
Publisher Date	2024-05-22
Access Restriction	Open
Rights License	This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2024 The Author(s)
Subject Keyword	balloon-expandable valve outcomes self-expanding valve transcatheter aortic valve replacement
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine