Comparing clinical outcomes between bicuspid and tricuspid aortic valve stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis
- VernacularTitle:经导管主动脉瓣置换术治疗二叶式与三叶式主动脉瓣狭窄疗效比较的系统评价与 Meta 分析
- Author:
Shidong LIU
1
;
Shuai DONG
1
;
Tao FANG
1
;
Xiang LEI
1
;
Bing SONG
2
Author Information
1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China
2. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China
- Publication Type:Journal Article
- Keywords:
Aortic valve stenosis;
bicuspid aortic valve;
transcatheter aortic valve replacement;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(06):693-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical outcomes of bicuspid aortic valve stenosis (BAV) and tricuspid aortic valve stenosis (TAV) after transcatheter aortic valve replacement (TAVR). Methods A computer-based search in PubMed, EMbase, The Cochrane Library, CBM, CNKI and Wanfang databases from their date of inception to March 2019 was conducted. Two reviewers independently screened the articles, extracted data and evaluated their quality. RevMan 5.3 and Stata 15.0 softwares were used for meta-analysis. Results The selected 15 cohort studies contained 45 770 patients, including 1 500 of BAV patients and 44 270 of TAV patients. The results showed that no statistical difference was found in postoperative in-hospital mortality [OR=1.29, 95%CI (0.91, 1.83), P=0.15], 30-day mortality [OR=1.23, 95%CI (0.86, 1.77), P=0.25], and 1-year mortality [OR=1.14, 95%CI (0.87, 1.50), P=0.33] between the two groups. The surgical success rate [OR=0.57, 95%CI (0.44, 0.74), P<0.01], postoperative bleeding events [OR=0.72, 95%CI (0.58, 0.91), P<0.01] and postoperative vascular injury [OR=0.68, 95%CI (0.47, 0.97), P=0.03] of patients in the BAV group were lower than those in the TAV group. The incidence of paravalvular leak in the BAV group was higher than that in the TAV group [OR=1.47, 95%CI (1.13, 1.90), P<0.01]. No significant difference was found between the two groups in terms of conversion to surgery, postoperative myocardial infarction, postoperative renal failure, postoperative neurologic events, postoperative valve gradient difference and pacemaker implantation. Conclusion Compared with TAV, the application of TAVR in BAV patients is feasible and effective.
