Factors That Prevent Progression to Transcatheter Aortic Valve Implantation (TAVI)

Dawson, L.; Dagan, M.; Koh, Youlin; Duffy, Stephen J.; Lew, Philip; Shaw, James A.; Walton, Antony

doi:10.1016/j.hlc.2018.07.004

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…This finding is not surprising given the differing anatomy between sexes. Women are known to have smaller peripheral vessels, which lends itself to increased risk of peri-procedural vascular injury [42][43][44]. We also found women were significantly less likely to experience a major bleed or acute kidney injury following TAVI while men experienced similar rates of bleeding and acute kidney injury regardless of the type of intervention [40].…”

Section: Summary Of Main Resultsmentioning

confidence: 52%

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Transcatheter Versus Surgical Aortic Valve Replacement: An Updated Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex

Dagan

Yeung

Stehli

et al. 2021

Heart, Lung and Circulation

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Background and Aims Women at increased surgical risk have been shown to have better outcomes with transcatheter aortic valve implantation (TAVI) as compared to surgical valve replacement (SAVR). With the scope of TAVI moving into low-surgical risk patients, we aimed to update the current literature to include the new low-risk randomised controlled trial (RCT) data in investigating outcomes by sex. Methods We systematically searched MEDLINE (Ovid), PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and reference lists for relevant RCTs comparing TAVI to SAVR published prior to 4 May 2020. Data extraction was performed by two independent authors and included trial design details, baseline characteristics and outcome data stratified by sex. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Quantitative synthesis of pooled data was performed using Mantel-Haenszel fixed or random effects model. Q-statistic and the I 2 test were used for assessment of heterogeneity. Results Our search yielded eight RCTs included in the final quantitative synthesis. The overall pooled cohort was 8,040, of whom 41.4% were female. Women had significantly lower rates of one-year all-cause mortality (12.2% vs 17.7%, pooled OR 0.59, 95% CI 0.40-0.86) and one-year composite endpoint (9.7% vs 12.4%, pooled OR 0.73, 95% CI 0.58-0.92) with TAVI as compared to SAVR. The selective mortality benefit with TAVI over SAVR in women did not persist to 5 years (pooled HR 1.01, 95% CI 0.87-1.17). At 30 days, women demonstrated lower rates of major bleeding and acute kidney injury following TAVI compared to SAVR. For men, these outcomes were similar regardless of type of intervention. Both sexes were at increased risk of major vascular complications with TAVI as compared to SAVR, however women demonstrated nearly double the odds of major vascular complication with TAVI compared to men. Conclusion Our updated meta-analysis demonstrates that at one-year women undergoing TAVI have significantly lower mortality and better safety outcomes compared to those undergoing SAVR. These benefits are not seen in men. In the new low-risk era, these results are ever more important for guiding appropriate patient selection.

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Section: Summary Of Main Resultsmentioning

confidence: 52%

“…These outcomes are potentially inter-related, with the volume loss associated with major bleeding likely resulting in pre-renal acute kidney injury. Again, the difference in rates of major bleeding between sexes are likely associated with differing anatomy [42][43][44].…”

Section: Summary Of Main Resultsmentioning

confidence: 99%

Transcatheter Versus Surgical Aortic Valve Replacement: An Updated Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex

Dagan

Yeung

Stehli

et al. 2021

Heart, Lung and Circulation

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Coronary Artery Disease Assessed by Computed Tomography-Based Leaman Score in Patients With Low-Risk Transcatheter Aortic Valve Implantation

Ozaki

García‐García

Rogers

et al. 2020

The American Journal of Cardiology

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Open-chest or transcatheter aortic valve implantation?

Chernyavsky¹,

Александрович²,

Strelkov³

et al. 2021

Medical Journal of the Russian Federation

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This literature review focuses on the choice of treatment strategies in patients with aortic stenosis. The main surgical techniques for this condition are presented. The rationale for the efficiency of transcatheter aortic valve implantation is provided. The results of studies comparing the outcomes of surgical and endovascular correction of aortic stenosis are analyzed. Particular attention is paid to the treatment choices in patients with aortic stenosis and a history of coronary artery bypass grafting. Conclusions on the perspectives of transcatheter aortic valve implantation in this cohort of patients are reached.

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Factors That Prevent Progression to Transcatheter Aortic Valve Implantation (TAVI)

Cited by 3 publications

References 26 publications

Transcatheter Versus Surgical Aortic Valve Replacement: An Updated Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex

Transcatheter Versus Surgical Aortic Valve Replacement: An Updated Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex

Coronary Artery Disease Assessed by Computed Tomography-Based Leaman Score in Patients With Low-Risk Transcatheter Aortic Valve Implantation

Open-chest or transcatheter aortic valve implantation?

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