Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY)

Li, Yiming; Xiong, Tian-Yuan; Xu, Kai; Fang, Zhenfei; Jiang, Lei; Jin, Jun; He, Shenghu; Yang, Yi‐Ning; He, Jingjing; Jia, Yixin; Zhang, Yi; Peng, Yong; Feng, Yuan; Chen, Mao

doi:10.1097/cm9.0000000000001882

Cited by 8 publications

(23 citation statements)

References 32 publications

(74 reference statements)

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“…TAVR is significantly less common in China than it is in the United States for technical and economic reasons. Despite the fact that no nationwide data on TAVRs has been published in China, the largest multi-center retrospective study [ 19 ], covering seven major sites in China, found that only 1204 patients have had TAVRs between April 2012 and November 2020 in these seven prominent cardiac centers.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

Lin

Gong

et al. 2022

JCDD

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The goal of this study is to summarize valvular surgery data from the Chinese Cardiac Surgery Registry (CCSR) and compare it to the most recent data from the Society of Thoracic Surgeons (STS). From 2016 to 2018, a total of 34,386 cases of the seven most common valvular surgical procedures was obtained from the CCSR. We calculated the proportions of different procedures in the CCSR cohort (n = 34,386) as well as the change in operation volume for each procedure. We also compiled rates of postoperative in-hospital mortality and five major complications across all procedures. All of the results were compared to the STS data. The CCSR and STS data showed divergent trends in valvular heart disease features and operation volume. Although the proportion of MV repair in the CCSR (13.7%) data was lower than in the STS data (23.2%), it demonstrated a substantial upward trend. In terms of operation volume, the CCSR data showed an upward trend, but the STS data showed a downward trend. CCSR procedures showed lower mortality (2% vs. 2.6%), reoperation (2.8% vs. 4.3%), and permanent stroke (0.5% vs. 1.6%) rates than STS procedures but higher rates of prolonged ventilation (22.4% vs. 10.4%) and renal failure (5.6% vs. 3.2%). Valvular surgery quality in China’s leading cardiac hospitals is roughly comparable to that in the United States. China, on the other hand, has some shortcomings that need improvement.

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Section: Discussionmentioning

confidence: 99%

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

Lin

Gong

et al. 2022

JCDD

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“…Only five studies reported procedural and in-hospital mortality, with a total sample size of 3174 [16,21,22,29,30]. The mean in-hospital mortality rate was 2.28% [16,21,22,29,30]. Among the five studies, Barbash et al [29] (2015) reported the highest in-hospital mortality (3.17%, 42/1327) in Israel.…”

Section: In-hospital Mortalitymentioning

confidence: 99%

“…Eighteen studies reported that a total of 224 out of 13,509 patients died by 30 days after TAVI, giving a weighted mean for 30-day mortality rate of 1.66%, with a weighted standard deviation of 1.2% [8,[17][18][19][20][21][22][23][24][25][26][28][29][30][31][32][33].…”

Section: -Day Mortalitymentioning

confidence: 99%

“…Table 4 (Ref. [8,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]) shows an overview of the acute procedural complications reported by the included studies as outcomes.…”

Section: Complicationsmentioning

confidence: 99%

“…A forest plot presenting all the reporting studies is shown in Fig. 9 [8,16,[18][19][20][21][22][24][25][26][27][30][31][32][33].…”

Section: Major Vascular Complicationsmentioning

confidence: 99%

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Transcatheter Aortic Valve Implantation Outcomes and Challenges in Asia: A Systematic Review and Meta-Analysis

Rivera¹,

Luna²,

Ansay³

et al. 2023

Rev. Cardiovasc. Med.

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Background: Aortic stenosis (AS) is the world's most prevalent heart valve disease. Transcatheter aortic valve replacement (TAVR) or Implantation (TAVI) is widely available yet adopting this procedure in Asia has been slow due to high device cost, the need for specific training programs, and the lack of specialized heart teams and dedicated infrastructures. The limited number of randomized controlled trials describing TAVI outcomes among the Asian population hampered the approval for medical reimbursements as well as acceptance among surgeons and operators in some Asian countries. Methods: A comprehensive medical literature search on TAVI and/or TAVR performed in Asian countries published between January 2015 and June 2022 was done through MEDLINE and manual searches of bibliographies. The full text of eligible articles was obtained and evaluated for final analysis. The event rates for key efficacy and safety outcomes were calculated using the data from the registries and randomized controlled trials. Results: A total of 15,297 patients were included from 20 eligible studies. The mean patient age was 82.88 ± 9.94 years, with over half being females (62.01%). All but one study reported Society of Thoracic Surgeons (STS) scores averaging an intermediate risk score of 6.28 ± 1.06%. The mean logistic European Systems for Cardiac Operations Risk Evaluation (EuroSCORE) was 14.85. The mean baseline transaortic gradient and mean aortic valve area were 50.93 ± 3.70 mmHg and 0.64 ± 0.07 cm 2 , respectively. The mean procedural success rate was 95.28 ± 1.51%. The weighted mean 30-day and 1-year all-cause mortality rate was 1.66 ± 1.21% and 8.79 ± 2.3%, respectively. The mean average for stroke was 1.98 ± 1.49%. The acute kidney injury (AKI) rate was 6.88 ± 5.71%. The overall major vascular complication rate was 2.58 ± 2.54%; the overall major bleeding rate was 3.88 ± 3.74%. Paravalvular aortic regurgitation rate was 15.07 ± 9.58%. The overall rate of pacemaker insertion was 7.76 ± 4.6%. Conclusions: Compared to Americans and Europeans, Asian patients who underwent TAVI had lower all-cause mortality, bleeding, and vascular complications, however, had a higher rate of postprocedural aortic regurgitation. More studies with greater sample sizes are needed among Asian patients for a more robust comparison.

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Clinical outcomes and the impact of valve morphology for transcatheter aortic valve replacement in bicuspid aortic valves: A systematic review and meta‐analysis

Gupta,

Mahmoudi,

Behnoush

et al. 2023

Cathet Cardio Intervent

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BackgroundBicuspid aortic valve (BAV) is present in approximately 0.5%–2% of the general population, causing significant aortic stenosis (AS) in 12%–37% of affected individuals. Transcatheter aortic valve replacement (TAVR) is being considered the treatment of choice in patients with symptomatic AS across all risk spectra.AimAim Our study aims to compare TAVR outcomes in patients with BAV versus tricuspid aortic valves (TAV).MethodsA comprehensive literature search was performed in PubMed, Web of Science, and Cochrane trials. Studies were included if they included BAV and TAV patients undergoing TAVR with quantitative data available for at least one of our predefined outcomes. Meta‐analysis was performed by the random‐effects model using Stata software.ResultsFifty studies of 203,288 patients were included. BAV patients had increased 30‐day all‐cause mortality (odds ratio [OR] = 1.23 [1.00–1.50], p = 0.05), in‐hospital stroke (OR = 1.39 [1.01–1.93], p = 0.05), in‐hospital and 30‐day PPI (OR = 1.13 [1.00–1.27], p = 0.04; OR = 1.16 [1.04–1.13], p = 0.01) and in‐hospital, 30‐day and 1‐year aortic regurgitation (AR) (OR = 1.48 [1.19–1.83], p < 0.01; OR = 1.79 [1.26–2.52], p < 0.01; OR = 1.64 [1.03–2.60], p = 0.04). Subgroup analysis on new‐generation valves showed a reduced 1‐year all‐cause mortality (OR = 0.86 [CI = 0.75–0.98], p = 0.03), despite higher in‐hospital and 30‐day PPI (OR = 0.1.21 [1.04–1.41], p = 0.01; OR = 1.17 [1.05–1.31], p = 0.01) and in‐hospital AR (OR = 1.62 [1.14–2.31], p = 0.01) in the BAV group. The quality of included studies was moderate‐to‐high, and only three analyses presented high heterogeneity.ConclusionTAVR is associated with comparable outcomes in patients with BAV and TAV. Careful selection of BAV cases by preprocedural assessment of valve anatomy and burden of calcification, pre‐ and post‐procedural dilation, and implementing newer generations of valves may improve the safety and efficacy of TAVR in BAV patients.

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Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY)

Abstract: Supplemental Digital Content is available in the text

Cited by 8 publications

References 32 publications

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

Transcatheter Aortic Valve Implantation Outcomes and Challenges in Asia: A Systematic Review and Meta-Analysis

Clinical outcomes and the impact of valve morphology for transcatheter aortic valve replacement in bicuspid aortic valves: A systematic review and meta‐analysis

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