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Meta‐analysis of stroke and mortality rates in patients undergoing valve‐in‐valve transcatheter aortic valve replacement

Journal of the American Heart Association Mar 17, 2021

Macherey S, Meertens M, Mauri V, et al. - Researchers conducted this review to evaluate all studies on valve‐in‐valve (viv) transcatheter aortic valve replacement (TAVR) focusing on short‐ and mid‐term stroke and death rates relative to redo surgical aortic valve replacement or native TAVR procedures. A qualitative analysis was performed with 23 eligible studies. As unveiled by quantitative synthesis of data from 8,509 patients, viv‐TAVR was related to mean 30‐day stroke and death rates of 2.2% and 4.2%, respectively. By pooled data analysis, 30‐day stroke rate, 30‐day mortality, and 1‐year mortality did not differ significantly between viv‐TAVR and comparator treatment. This review represents the first one comparing the risk for stroke as well as death rates in viv‐TAVR procedures with native TAVR approach and provides substantial data for the clinical routine. This work also affords the most comprehensive study on ischemic cerebrovascular events and early mortality in patients receiving viv‐TAVR. Findings indicate the suitability of viv‐TAVR as a treatment choice for degenerated bioprostheses in this era with increasing numbers of bioprosthetic valves employed in younger patients.

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