Meta-analysis of transcatheter aortic valve implantation in patients with stenotic bicuspid vs tricuspid aortic valve
The American Journal of Cardiology Feb 17, 2021
Majmundar M, Kumar A, Doshi R, et al. - Researchers analyzed studies comparing clinical, procedural, as well as post-procedural echocardiographic results in bicuspid aortic stenosis (BAS) vs tricuspid aortic stenosis (TAS) patients who received transcatheter aortic valve implantation (TAVI). In this meta-analysis with meta-regression, they included pertinent articles identified from PubMed and Cochrane databases. Final analysis involved 19 articles. The two groups did not differ in terms of risk of 30-day death, 1-year mortality, 30-day cardiovascular mortality, major and/or life-threatening bleeding, major vascular complications, acute kidney injury, permanent pacemaker implantation, device success, annular rupture, after-procedural aortic valve area, and mean pressure gradient. Based on findings, performing TAVI in surgically ineligible patients with BAS was concluded to be feasible, though a higher incidence of certain complications, such as stroke, conversion to surgery, second valve implantation, and paravalvular leak, was evident in BAS patients vs TAS patients, which needs to be discussed with the patient during the decision-making process.
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