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Safety and efficacy of transcatheter aortic valve implantation in stenotic bicuspid aortic valve compared to tricuspid aortic valve: a systematic review and meta-analysis.

Zghouzi, Mohamed; Osman, Heba; Ullah, Waqas; Suleiman, Abdul-Rahman; Razvi, Parveen; Abdalrazzak, Mukhlis; Rabbat, Firas; Alraiyes, Mowaffak; Sattar, Yasar; Bagur, Rodrigo; Paul, Timir; Matetic, Andrija; Mamas, Mamas A.; Lakkis, Nasser; Chadi Alraies, M.

Authors

Mohamed Zghouzi

Heba Osman

Waqas Ullah

Abdul-Rahman Suleiman

Parveen Razvi

Mukhlis Abdalrazzak

Firas Rabbat

Mowaffak Alraiyes

Yasar Sattar

Rodrigo Bagur

Timir Paul

Andrija Matetic

Nasser Lakkis

M. Chadi Alraies



Abstract

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective alternative to surgical replacement for tricuspid aortic valve (TAV) stenosis. However, utilization of TAVI for aortic stenosis in bicuspid aortic valve (BAV) compared to TAV remains controversial. METHODS: We queried online databases with various keywords to identify relevant articles. We compared major cardiovascular events and procedural outcomes using a random effect model to calculate odds ratios (OR). RESULTS: We included a total of 22 studies comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled analysis, there were no difference in TAVI for BAV vs. TAV for all-cause mortality, cardiovascular mortality, myocardial infarction (MI), vascular complications, acute kidney injury (AKI), coronary occlusion, annulus rupture, and reintervention/reoperation between the groups. The incidence of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42; 95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26) was less in the TAV group compared to the BAV group, while incidence of life-threatening bleeding was higher in the TAV group. Subgroup analysis mirrored pooled outcomes except for all-cause mortality. CONCLUSION: The use of TAVI for the treatment of aortic stenosis in selective BAV appears to be safe and effective.

Acceptance Date Jun 30, 2022
Publication Date Jul 5, 2022
Journal Expert Review of Cardiovascular Therapy
Print ISSN 1477-9072
Publisher Taylor and Francis
Pages 581 - 588
DOI https://doi.org/10.1080/14779072.2022.2094368
Publisher URL https://www.tandfonline.com/doi/abs/10.1080/14779072.2022.2094368?journalCode=ierk20

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