Meta-Analysis of Outcomes and Evolution of Pulmonary Hypertension Before and After Transcatheter Aortic Valve Implantation

Tang, May; Liu, Xianbao; Lin, Chujun; He, Yuxin; Cai, Xianlei; Xu, Qian; Hu, Po; Gao, Feng; Jiang, Jianwen; Lin, Xiaoping; Zhu, Qionghua; Wang, Lihan; Kong, Huijia; Yu, Yunxian; Wang, Jianan

doi:10.1016/j.amjcard.2016.09.015

Cited by 43 publications

(41 citation statements)

References 27 publications

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“…Importantly, persistence of PH after TAVR appeared to be associated with higher 2-year mortality; however, there was significant study heterogeneity in the evaluation of its changes. 17 Therefore, the PH response after TAVR is perhaps more important than the baseline PH severity; as it appears also to dictate outcomes. 18–20 If the pulmonary vasculature has remodeled because of the chronic pulmonary venous congestion, then PH is likely irreversible and will persist after TAVR.…”

Section: Ph In As: Not a Benign Bystandermentioning

confidence: 99%

Comprehensive Right-Sided Assessment for Transcatheter Aortic Valve Replacement Risk Stratification: Time for a Change

Cavalcante

Simon

Chan

2017

Journal of the American Society of Echocardiography

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Section: Ph In As: Not a Benign Bystandermentioning

confidence: 99%

Comprehensive Right-Sided Assessment for Transcatheter Aortic Valve Replacement Risk Stratification: Time for a Change

Cavalcante

Simon

Chan

2017

Journal of the American Society of Echocardiography

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“…A meta‐analysis by Kokkinidis et al of 22 studies showed that baseline PH was associated with increased late (>6‐month) cardiac and all‐cause mortality after TAVI. Also in a meta‐analysis by Tang et al of 16 studies enrolling 9,204 patients, baseline PH was a predictor of increased (1) 30‐day all‐cause and cardiovascular mortality and incidence of acute kidney injury; (2) 1‐year all‐cause and cardiovascular mortality and incidence of stroke; and (3) 2‐year all‐cause mortality after TAVI. As described by the simplified Bernoulli equation, the estimation of systolic pulmonary artery pressure is generally based on the peak TR velocity (TRV) taking into account right atrial pressure.…”

Section: Discussionmentioning

confidence: 96%

“…Also in a meta-analysis by Tang et al 30 of 16 studies enrolling 9,204 patients, baseline PH was a predictor of increased (1) 30-day all-cause and cardiovascular mortality and incidence of acute kidney injury;…”

Section: Pulmonary Hypertension and Tr Velocitymentioning

confidence: 96%

Impact of concurrent tricuspid regurgitation on mortality after transcatheter aortic‐valve implantation

Takagi

Hari

Kawai

et al. 2018

Cathet Cardio Intervent

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Objectives To determine whether concomitant tricuspid regurgitation (TR) is associated with increased mortality in patients with severe aortic stenosis (AS) undergoing transcatheter aortic‐valve implantation (TAVI), we performed a meta‐analysis of currently available studies. Methods MEDLINE and EMBASE were searched through May 2018. We included comparative or cohort studies enrolling patients with AS undergoing TAVI and reporting early (in‐hospital or 30‐day) and late (including early) all‐cause mortality in patients stratified by baseline TR grade. An odds ratio (OR) of early mortality and a hazard ratio (HR) of late mortality with its 95% CI for significant versus non‐significant (typically, ≥moderate versus

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“…Previous studies that included patients treated by different access routes showed nonconsistent results with increased or comparable short term mortality in patients with coexisting pulmonary hypertension. A recent meta‐analysis of the relevance of baseline PH on the outcome of TAVR patients showed an increased 30 day mortality in patients with coexisting PH underlining the relevance of PH in the management of TAVR. Off note, PH was not uniformly defined which also may complicate the comparison of study results.…”

Section: Discussionmentioning

confidence: 99%

Patients with severe aortic stenosis and coexisting pulmonary hypertension treated by transapical transcatheter aortic valve replacement—Is there a need for increased attention?

Keymel

Papadopoulos

Minol

et al. 2019

Cathet Cardio Intervent

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Objectives: Aim of this study is to elucidate the impact of pulmonary hypertension on patients treated with a transapical aortic valve replacement.Background: In patients with aortic stenosis (AS) the coexistence of pulmonary hypertension (PH) is associated with increased peri-operative risk for surgical aortic valve replacement. For transcatheter aortic valve replacement (TAVR), it is unknown whether transapical TAVR (TA-TAVR) is associated with increased peri-interventional risk in PH patients. Methods:We performed a single center analysis in 189 patients with severe AS with (AS + PH) or without PH (AS − PH) undergoing TA-TAVR. PH was defined by mean pulmonary artery pressure ≥25 mmHg assessed by right heart catheterization (exclusion of 64 patients due to missing results). As the primary endpoint a combination of 30-day mortality or cardiopulmonary resuscitation (CPR) was analyzed.Results: Seventy three patients (58.4%) had PH. Increased peri-interventional risk in AS + PH patients was reflected by an increased rate of the primary endpoint in comparison to AS − PH patients (24.7 vs. 3.8%; p = .002). A higher proportion of acute kidney injury (34.2 vs. 15.7%; p = .025) was found in AS + PH patients while AS − PH patients showed a higher rate of bleeding in comparison AS + PH patients (18.5 vs. 6.8% p = .050). Conclusion:Patients with AS + PH treated by TA-TAVR are at increased periinterventional risk for severe complications in comparison to AS − PH patients. Therefore, the identification of preventive therapeutic strategies is needed.

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Meta-Analysis of Outcomes and Evolution of Pulmonary Hypertension Before and After Transcatheter Aortic Valve Implantation

Cited by 43 publications

References 27 publications

Comprehensive Right-Sided Assessment for Transcatheter Aortic Valve Replacement Risk Stratification: Time for a Change

Comprehensive Right-Sided Assessment for Transcatheter Aortic Valve Replacement Risk Stratification: Time for a Change

Impact of concurrent tricuspid regurgitation on mortality after transcatheter aortic‐valve implantation

Patients with severe aortic stenosis and coexisting pulmonary hypertension treated by transapical transcatheter aortic valve replacement—Is there a need for increased attention?

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