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Although there was no significant difference in 30 day mortality, the newer ES3 valve reduced significantly residual paravalvular leakage. © 2016 Wiley Periodicals, Inc.

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applicability. We aimed to evaluate the clinical outcomes of all EPD's for TAVR.METHODS Pub Med and Cochrane serach trough June 2016 for all clinical studies that directly compared EPD to control group in highrisk patients undergoing TAVR using any type of access. Primary outcomes: 30 days stroke and patients who developed new brain lesions by DW-MRI brain. Secondary outcomes: mean number of lesions/patient, volume of lesions/patient and all-cause death. We used Cochrane Handbook of Systematic Reviews and RevMan 5.2 for statistical analysis.RESULTS Six studies provided a total of 366 patients; 177 in the EPD and 189 in the control group. 4 different EPD's were used. There was no difference in stroke rate between EPD and control groups (6.6% vs. 5.9%, p>0.05). There was no difference in number of patients who developed new DW-MRI brain lesions (82% vs. 87.8%, p>0.05). Secondary outcomes analysis disclosed no difference on the number of lesions/patient or mortality. There was a significant 10.73 ml (4.73-16.72) less lesion volume/patient in the EPD group compared to the control group (p<0.05).CONCLUSION Our analysis suggests that EPD can lead to significantly less lesion volumes post TAVR. Clinical relevance was not achieved as stroke and mortality were similar between groups. It is yet to be determined the clinical applicability of EPD's. Device differences should also be considered. Further randomized studies are warranted.