Meta‐analysis of complications in aortic valve replacement: Comparison of Medtronic‐Corevalve, Edwards‐Sapien and surgical aortic valve replacement in 8,536 patients

Jilaihawi, Hasan; Chakravarty, Tarun; Weiss, Robert E.; Fontana, Gregory P.; Forrester, James S.; Makkar, Raj

doi:10.1002/ccd.23368

Cited by 115 publications

(66 citation statements)

References 47 publications

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“…1 Similarly, Jilaihawi found a stroke rate of 2.2% versus 3.4%. 13 In neither analysis was the lower stroke rate with the transapical approach statistically significant, although a higher risk of mortality with the transapical approach was. There may be a small advantage to transapical antegrade access to the aortic valve in terms of neurological events, however any such benefit is small and overshadowed by other concerns.…”

mentioning

confidence: 89%

Cerebral Embolization During Transcatheter Aortic Valve Implantation

Webb

Barbanti

2012

Circulation

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T he recent success of transcatheter aortic valve implantation (TAVI) has been associated with a heightened awareness of the potential risks, particularly stroke. Recent meta-analyses report 30-day stroke rates of 3% to 4%, 1,2 and diffusion-weighted MRI studies have revealed new, clinically silent, cerebral lesions in 68% to 84% of patients undergoing TAVI. [3][4][5] Although the majority of patients undergoing TAVI benefit greatly in terms of quality of life and functional status, concerns about neurological disability remain.Transcranial Doppler (TCD) has been extremely helpful in clarifying the central role of cerebral embolism as the major cause of intraprocedural stroke. As Kahlert et al 4 report, cerebral microembolism occurs in essentially all patients undergoing TAVI. High-intensity transient signals, largely reflecting particulate emboli, are routinely detected during many invasive cardiac procedures. Nevertheless, it has been difficult to demonstrate that high-intensity transient signals correlate directly with stroke, and attempts to correlate high-intensity transient signals with biomarkers of neuronal injury have been inconsistent. 3,6 Importantly, TCD has provided considerable information about the relative contributions of the various elements of the TAVI procedure to the risk of cerebral embolization.

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mentioning

confidence: 89%

Cerebral Embolization During Transcatheter Aortic Valve Implantation

Webb

Barbanti

2012

Circulation

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“…genereux et al 50 , Jilaihawi et al 51 , and Moat et al 52 reported separate meta-analyses of TaVI studies across more than 3,500 patients, respectively. pooled TaVI outcomes were broadly similar as illustrated in Table 3.…”

Section: Clinical Outcomes After Tavi and The Importance Of Aortic Rementioning

confidence: 99%

Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis

Chung¹

2015

ICFJ

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Aortic stenosis remains the commonest form of valve disease in modern cardiology. With fifty years’ experience, surgical valve replacement remains the gold standard treatment for survival benefit, durability and symptomatic relief. Percutaneous transcatheter aortic valve replacement has recently gained a credible momentum for inoperable and very high risk patients with severe aortic stenosis. Early and medium term results have demonstrated a proven survival benefit over conservative management, with documented complication rates for stroke, vascular complications and pacemaker implantation. The evidence base for cost effectiveness and long-term results are eagerly anticipated.

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“…9,10,63 There is clear evidence that the risk of heart block that requires a permanent pacemaker is higher after CoreValve implantation, which might be due to the extended frame expanding into the left-ventricular outflow tract. 1,10,[63][64][65][66] Several studies have further suggested that paravalvular and central regurgitation might be more common after CoreValve implantation, 9,10,63 while others have been unable to demonstrate significant differences. 64 Some studies support that the SAPIEN valve might be associated with higher gradients and lower orifice areas, and that this valve might carry a higher risk of coronary artery obstruction.…”

Section: Types Of Transcatheter Heart Valvesmentioning

confidence: 99%

“…40 This is most likely to be due to the design of the CoreValve System. 1,10,40,[63][64][65][66]88,91,92 In view of the risk of delayed AV block, it has been recommended that patients be monitored for at least 24-48 hours post-procedure, perhaps for even longer after CoreValve implantation or if there are preexisting conduction abnormalities or any that are newly developed after TAVR. …”

Section: 82mentioning

confidence: 99%

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Transcatheter aortic valve replacement

Damberg¹,

Benstoem²,

Autschbach³

et al. 2013

RRCC

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Abstract:The standard treatment for symptomatic severe aortic valve stenosis is surgical aortic valve replacement. Over the last decade, transcatheter aortic valve replacement has emerged as an option for patients judged inoperable. It might also constitute an alternative for high-risk patients, even though which patients might benefit from this approach is still being discussed and remains controversial. Transcatheter heart valve replacement is a rapidly spreading technology. However, a number of problems still need to be addressed, such as paravalvular regurgitation, stroke rate, and postoperative conduction disturbances. Further, the durability of transcatheter heart valves remains unclear. Randomized clinical trials and long-term follow-up will help define the role of transcatheter heart valve replacement in aortic stenosis therapy.

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Meta‐analysis of complications in aortic valve replacement: Comparison of Medtronic‐Corevalve, Edwards‐Sapien and surgical aortic valve replacement in 8,536 patients

Abstract: Complications for elderly and high risk aortic stenosis patients being treated by TAVR appear comparable to those selected for SAVR in the real-world.

Cited by 115 publications

References 47 publications

Cerebral Embolization During Transcatheter Aortic Valve Implantation

Cerebral Embolization During Transcatheter Aortic Valve Implantation

Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis

Transcatheter aortic valve replacement

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