Meta-Analysis of the Prognostic Impact of Stroke Volume, Gradient, and Ejection Fraction After Transcatheter Aortic Valve Implantation

Eleid, Mackram F.; Goel, Kashish; Murad, M. Hassan; Erwin, Patricia J.; Suri, Rakesh M.; Greason, Kevin L.; Nishimura, Rick A.; Rihal, Charanjit S.; Holmes, David R.

doi:10.1016/j.amjcard.2015.06.027

Cited by 76 publications

(54 citation statements)

References 35 publications

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“…(7,11,13,14) Most studies that have shown reduced LVEF and AVG to be associated with an increase in mortality and HF after TAVR have not fully adjusted for stroke volume. (9,16) However, studies that have adjusted for stroke volume have similarly found that reduced LVEF and AVG are not independently associated with mortality and HF after TAVR. (11,14) The finding that patients with low flow had a greater need for blood transfusion was unexpected.…”

Section: Discussionmentioning

confidence: 99%

Impact of flow, gradient, and left ventricular function on outcomes after transcatheter aortic valve replacement

Carreras

Kaneko

Val

et al. 2017

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Impact of flow, gradient, and left ventricular function on outcomes after transcatheter aortic valve replacement

Carreras

Kaneko

Val

et al. 2017

Cathet Cardio Intervent

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“…In a meta-analysis of 7,673 patients with severe AS who underwent TAVR, patients with a low stroke volume index (< 35ml/m2), low gradient and low EF (< 30%) had significant higher mortality at follow up. But the overall low peri-procedural risk and high procedural success, makes TAVR a very vital option in patients with LFLG severe AS with rEF [17]. The patient described here was an elderly, frail, poorly functional due to underlying LFLG severe AS with rEF and was considered at a very high risk for SAVR (Euro score II mortality risk was 14.56%).…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement (TAVR) in Low Flow-Low Gradient Severe Aortic Stenosis without Cardiac Reserve

Sudhakaran¹,

Shah

Aparna³

et al. 2017

J.ATAMIS

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With accumulating positive evidence in favour of transcatheter aortic valve replacement (TAVR) over a surgical approach, it has replaced surgical AVR to become the mainstay of treatment for severe symptomatic aortic stenosis in patients with prohibitive and high surgical risk. There is significant surgical mortality and morbidity associated with surgical aortic valve replacement in patients with low flow-low gradient (LFLG) true severe aortic valve stenosis (AS) and severely reduced left ventricular ejection fraction (rEF) without contractile reserve (CR). CR is measured following use of dobutamine in an attempt to increase cardiac output by more than 20% while differentiating severe from pseudostenosis in some cases. The value of transcatheter aortic valve replacement (TAVR) over a surgical approach for these patients with rEF LFLG true severe AS and no CR is uncertain. We present a patient with LFLG severe AS and low left ventricular EF without contractile reserve who underwent TAVR and experienced significant improvement in their clinical status without complications.

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“…13 In TAVI patients, lower LVEF is a negative prognostic factor. 35 Also, patients with poor functional status have a 2-fold increase of death following TAVI. 36 Furthermore, LBBB is associated with increased cardiovascular mortality in a half of patients with chronic HF.…”

Section: New-onset Persistent Left Bundle Branch Block and Mortalitymentioning

confidence: 99%

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

Ando

Takagi

2016

Clinical Cardiology

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New-onset persistent left bundle branch block (NOP-LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP-LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP-LBBB patients after TAVI were included. The random-effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals. Adjusted HRs were utilized over unadjusted HRs or risk ratios when available. A total of 4049 patients (807 and 3242 patients with and without NOP-LBBB, respectively) were included. Perioperative (in-hospital or 30-day) and midterm all-cause mortality and midterm cardiovascular mortality were comparable between the groups. The NOP-LBBB patients experienced a higher rate of permanent pacemaker implantation (HR: 2.09, 95% confidence interval: 1.12-3.90, P = 0.021, I 2 = 83%) during midterm follow-up. We found that NOP-LBBB after TAVI resulted in higher permanent pacemaker implantation but did not negatively affect the midterm prognosis. Therefore, careful observation during the follow-up is required.

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Meta-Analysis of the Prognostic Impact of Stroke Volume, Gradient, and Ejection Fraction After Transcatheter Aortic Valve Implantation

Cited by 76 publications

References 35 publications

Impact of flow, gradient, and left ventricular function on outcomes after transcatheter aortic valve replacement

Impact of flow, gradient, and left ventricular function on outcomes after transcatheter aortic valve replacement

Transcatheter Aortic Valve Replacement (TAVR) in Low Flow-Low Gradient Severe Aortic Stenosis without Cardiac Reserve

The Prognostic Impact of New‐Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation: A Meta‐analysis

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