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Safety and efficacy of transcatheter aortic valve replacement for native aortic valve regurgitation: A systematic review and meta-analysis

Catheterization and Cardiovascular Interventions Feb 13, 2019

Rawasia WF, et al. - Researchers analyzed 19 studies (n =998 patients) from MEDLINE, Scopus, and Cochrane CENTRAL, to analyze the available literature on using transcatheter aortic valve replacement (TAVR) for native aortic regurgitation (AR). These studies included at least 5 patients undergoing TAVR for native AR and reported 30-day mortality, myocardial infarction, stroke, major bleeding, postprocedural moderate to severe AR, and device success. They reported 86.2% rate of procedural success per Valve Academic Research Consortium – 2 (VARC-2) criteria. Thirty-day mortality was 11.9% (9.4%–14.7%). Lower 30-day mortality and higher device success were observed with the use of new generation valves vs early generation valves, as revealed in subgroup analysis. In patients who received purpose-specific valves vs nonpurpose specific valves, higher device success was reported. Overall, acceptable procedural success but increased early mortality was reported for TAVR for native AR. However, newer valves granted increased safety and the efficacy of the procedure.
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