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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Wang, Baiqiang Mei, Zeyuan Ge, Xiao Li, Yunyi Zhou, Quan Meng, Xiao An, Guipeng |
| Abstract | Background The postoperative outcomes of transcatheter aortic valve replacement (TAVR) with the new generation of self-expanding valves (SEV) and balloon-expandable valves (BEV) remain uncertain. Methods We conducted a meta-analysis based on randomized controlled trials (RCTs) and propensity score-matched (PSM) studies to evaluate the performance of the new generation TAVR devices, with a focus on Edwards SAPIEN 3/Ultra BEV, Medtronic Evolut R/PRO SEV, and Boston ACURATE neo SEV. Our primary endpoints were mortality and complications at both 30 days and one year post-operation. Results A total of 4 RCTs and 14 PSM studies were included. Our findings showed no significant difference between SEV and BEV regarding 30-day and 1-year mortality rates. ACURATE SEV required less permanent pacemaker implantation (PPI) at 30-day as compared to SAPIEN BEV, while Evolut SEV required a higher rate of PPI than SAPIEN BEV. The incidence of stroke, major or life-threatening bleeding (MLTB), major vascular complications (MVC), coronary artery obstruction (CAO) and acute kidney injury (AKI) did not differ significantly between the two groups. SEV had a larger effective orifice area (EOA) and lower mean transvalvular gradients (MPG) compared to BEV. However, there was an increased risk of paravalvular leakage (PVL) associated with SEV. Conclusions In terms of 30-day mortality, stroke, bleeding, MVC, AKI, CAO, and one-year mortality, there was comparability between the two valve types following TAVR. SEV was associated with better hemodynamic outcomes, except for a higher incidence of PVL. Compared to SAPIEN BEV, ACURATE SEV had a lower risk of PPI at 30 days, while Evolut SEV was associated with a higher risk of PPI. These findings underscore the importance of personalized valve selection. |
| Related Links | https://bmccardiovascdisord.biomedcentral.com/counter/pdf/10.1186/s12872-023-03397-3.pdf |
| Ending Page | 18 |
| Page Count | 18 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712261 |
| DOI | 10.1186/s12872-023-03397-3 |
| Journal | BMC Cardiovascular Disorders |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-07-31 |
| Access Restriction | Open |
| Subject Keyword | Cardiology Cardiac Surgery Angiology Blood Transfusion Medicine Internal Medicine Medicine Public Health Transcatheter aortic valve replacement Self-expanding valves Balloon-expandable valves New generation valves Meta-analysis Medicine/Public Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
| Journal Impact Factor | 2/2023 |
| 5-Year Journal Impact Factor | 2.3/2023 |
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