Comparison of patient-prothesis mismatch after surgical aortic valve replacement and transcatheter aortic valve implantation

Yılmaz, Bilge Ecemiş; Karacalilar, Mehmet; Ersoy, Burak; Onan, Burak

doi:10.5606/tgkdc.dergisi.2019.17174

Cited by 2 publications

(2 citation statements)

References 21 publications

(99 reference statements)

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“…Of note, certain confounders, including differences in baseline clinical parameters (higher incidence of obesity in the SAVR group) and differences in baseline echocardiographic parameters, were not controlled for in this trial. Another study comparing the use of supra‐annular SAVR vs TAVR bioprostheses in high‐risk patients found no difference in the prevalence of PPM or short‐term mortality between the two groups 50 …”

Section: Discussionmentioning

confidence: 99%

“…Another study comparing the use of supra-annular SAVR vs TAVR bioprostheses in high-risk patients found no difference in the prevalence of PPM or short-term mortality between the two groups. 50 While short term outcomes in low-, intermediate-, and high-risk candidates suggest that the risk of PPM may be lower in TAVR, there is a currently a lack of data on intermediate-and long-term outcomes.…”

Section: The Risk Of Ppm In Savr Versus Tavrmentioning

confidence: 99%

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Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Alnajar

Hamad

Azhar

et al. 2022

Journal of Cardiac Surgery

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Background The hemodynamics of most prosthetic valves are often inferior to that of the normal native valve, and a significant proportion of patients undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) have high residual transaortic pressure gradients due to prosthesis–patient mismatch (PPM). As the experience with TAVR has increased and long‐term outcomes are reported, a close look at the PPM literature is required in light of new evidence. Methods For this review, we searched the Embase, Medline, and Cochrane databases from 2000 to 2022. Articles reporting PPM as an outcome following aortic valve replacements were identified and reviewed. Results The impact of PPM on clinical outcomes in aortic valve replacement has not been clear as multiple studies failed to report PPM incidence. However, the PPM outcomes after SAVR vary more widely than after TAVR, ranging from 8% to 80% in SAVR and from 24% to 35% in TAVR. Incidence of severe PPM following redo SAVR ranges from 2% to 9% and following valve‐in‐valve TAVR is from 14% to 33%, however, while PPM is higher in valve‐in‐valve TAVR, patients had better survival rates. Conclusions The gap between valve performance and clinical outcomes in SAVR and TAVR could be reduced by carefully selecting patients for either treatment option. Understanding predictors of PPM can add to the safety, effectiveness, and increased survival benefit of both SAVR and TAVR.

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Section: Discussionmentioning

confidence: 99%

Section: The Risk Of Ppm In Savr Versus Tavrmentioning

confidence: 99%

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Alnajar

Hamad

Azhar

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

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Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: A systematic review and meta‐analysis

Wang

Xia

et al. 2021

Journal of Cardiac Surgery

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Background: Transcatheter aortic valve replacement (TAVR) is a less invasive treatment than surgery for severe aortic stenosis. However, its use is restricted by the fact that many patients eventually require permanent pacemaker implantation (PPMI). This meta-analysis was performed to identify predictors of post-TAVR PPMI. Methods:The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Relevant studies that met the inclusion criteria were included in the pooling analysis after quality assessment. Results:After pooling 67 studies on post-TAVR PPMI risk in 97,294 patients, balloon-expandable valve use was negatively correlated with PPMI risk compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed that history of coronary artery bypass grafting and higher Society of Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV utilization. Patients with pre-existing cardiac conduction abnormalities in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI:1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also increased PPMI risk. Although the trans-femoral approach was positively correlated with PPMI risk, the trans-apical pathway showed no statistical difference to the trans-femoral pathway.The approach did not increase PPMI risk in patients with STS scores >8. Patientprosthesis mismatch did not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also analyzed implantation depth and found no difference between patients with PPMI after TAVR and those without.Conclusions: SEV selection, pre-existing cardiac conduction abnormality, and transfemoral pathway selection are positively correlated with PPMI after TAVR. Preexisting left bundle branch block, patient-prosthesis mismatch, and implantation depth did not affect the risk of PPMI after TAVR.

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Comparison of patient-prothesis mismatch after surgical aortic valve replacement and transcatheter aortic valve implantation

Cited by 2 publications

References 21 publications

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Surgical versus transcatheter aortic valve replacement: Impact of patient‐prosthesis mismatch on outcomes

Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: A systematic review and meta‐analysis

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