Meta-Analysis of Valve-in-Valve Transcatheter Aortic Valve Implantation Versus Redo-surgical Aortic Valve Replacement in Failed Bioprosthetic Aortic Valve
Section snippets
Methods
We conducted a comprehensive review of previous publications of all relevant studies through August 2020. We searched PUBMED, EMBASE, and COCHRANE databases. We included studies that met our criteria of: (1) the study compared clinical outcomes between ViV- TAVI versus Redo-SAVR in patients with failed bioprosthetic aortic valve, (2) the study reported more than one clinical outcome. The meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and
Results
Twelve retrospective observational studies were included with a total of 8,430 patients (Figure 1).5,6,15,16,7, 8, 9, 10, 11, 12, 13, 14 The median-weighted follow up period was 1.74 years. Characteristics of included studies and patients are described in Tables 1 and 2. A pooled analysis of the data showed no significant difference in all-cause mortality between ViV-TAVI and Redo-SAVR groups (OR 1.15; 95% CI 0.93 to 1.43; p = 0.21, I2=0%) (Figure 2).Meanwhile, procedural mortality (OR 0.41;
Discussion
Over the past 2 decades, more bioprosthetic valves have been utilized in comparison to mechanical valves.17 Since bioprosthetic valves degenerate within 10 years and the general population is getting older, managing degenerating bioprosthetic valves is currently a common entity and it is expected to increase exponentially. TAVI for native aortic stenosis has been studied extensively and has been proven to be non-inferior to SAVR in patients with all surgical risks. However, the data that
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We the undersigned declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere.
We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.
We understand that the Corresponding Author is the sole contact
Declaration of Interests
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Paravalvular Leak After Transcatheter Aortic Valve Implantation Its Incidence, Diagnosis, Clinical Implications, Prevention, Management, and Future Perspectives: A Review Article
2022, Current Problems in CardiologyCitation Excerpt :The outcome was similar in terms of safety and efficacy for those with ViV and those with single valve at 1-year follow-up.34 A meta-analysis of studies that compared the safety and efficacy of ViV-TAVI and redo-SAVR in failed bioprosthetic valves showed that of ViV-TAVI was safe and feasible in patients at high surgical risk.35 Interventional closure of PVL after TAVI has been described for both self-expandable and balloon expandable prosthesis.
Outcomes in Valve-in-Valve Transcatheter Aortic Valve Implantation
2022, American Journal of CardiologyCitation Excerpt :However, rates of readmission and longer-term mortality were higher in patients with ViV-TAVI.3,6,7,30 ViV-TAVI procedures are associated with higher postprocedural gradients and more paravalvular leakage, which may lead to worse long-term outcomes.30,31 Data on the durability of ViV-TAVI are limited.
Strut Inversion During Valve-in-Valve Transcatheter Aortic Valve Replacement: An Unknown Complication?
2022, JACC: Case ReportsCitation Excerpt :Recent evidence indicates that ViV TAVI is feasible and is a safer alternative to redo AVR.1 A recent meta-analysis in a large population showed ViV TAVI to be associated with lower rates of 30-day mortality, stroke, permanent pacemaker implantation, major bleeding, and shorter hospital stay.2 Both self-expanding and balloon-expandable valves are used for ViV TAVI, and the common complications associated with them are valve embolization, coronary obstruction, high residual gradients, and valve thrombosis.3-5