Imperial College London
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Professor Thanos Athanasiou MD PhD MBA FECTS FRCS

Faculty of Medicine, Department of Surgery & Cancer

Professor of Cardiovascular Sciences
 
 
 
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Contact

 

t.athanasiou

 
 
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Location

 

1022Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sá:2022:10.1111/jocs.16840,
author = {Sá, MP and Jacquemyn, X and Tasoudis, PT and Van, den Eynde J and Erten, O and Dokollari, A and Torregrossa, G and Sicouri, S and Weymann, A and Ruhparwar, A and Athanasiou, T and Ramlawi, B},
doi = {10.1111/jocs.16840},
journal = {J Card Surg},
pages = {3300--3310},
title = {Immediate and late outcomes of transcatheter aortic valve implantation versus surgical aortic valve replacement in bicuspid valves: Meta-analysis of reconstructed time-to-event data.},
url = {http://dx.doi.org/10.1111/jocs.16840},
volume = {37},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with aortic stenosis and bicuspid aortic valve (BAV) must be better investigated. METHODS: A meta-analysis including studies published by January 2022 reporting immediate outcomes (in-hospital death, stroke, acute kidney injury [AKI], major bleeding, new permanent pacemaker implantation [PPI], paravalvular leakage [PVL]), mortality in the follow-up (with Kaplan-Meier curves for reconstruction of individual patient data). RESULTS: Five studies met our eligibility criteria. No statistically significant difference was observed for in-hospital death, stroke, AKI, and PVL. TAVI was associated with lower risk of major bleeding (odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.12-0.69; p = .025), but higher risk of PPI (OR: 2.00; 95% CI: 1.05-3.77; p = .041). In the follow-up, mortality after TAVI was significantly higher in the analysis with the largest samples (HR: 1.24, 95% CI: 1.01-1.53, p = .043), but no statistically significant difference was observed with risk-adjusted populations (HR: 1.06, 95% CI: 0.86-1.32, p = .57). Landmark analyses suggested a time-varying risk with TAVI after 10 and 13 months in both largest and risk-adjusted populations (HR: 2.13, 95% CI: 1.45-3.12, p < .001; HR: 1.7, 95% CI: 1.11-2.61, p = .015, respectively). CONCLUSION: Considering the immediate outcomes and comparable overall survival observed in risk-adjusted populations, TAVI can be used safely in selected BAV patients. However, a time-varying risk is present (favoring SAVR over TAVI at a later timepoint). This finding was likely driven by higher rates of PPI with TAVI.
AU  - Sá,MP
AU  - Jacquemyn,X
AU  - Tasoudis,PT
AU  - Van,den Eynde J
AU  - Erten,O
AU  - Dokollari,A
AU  - Torregrossa,G
AU  - Sicouri,S
AU  - Weymann,A
AU  - Ruhparwar,A
AU  - Athanasiou,T
AU  - Ramlawi,B
DO  - 10.1111/jocs.16840
EP  - 3310
PY  - 2022///
SP  - 3300
TI  - Immediate and late outcomes of transcatheter aortic valve implantation versus surgical aortic valve replacement in bicuspid valves: Meta-analysis of reconstructed time-to-event data.
T2  - J Card Surg
UR  - http://dx.doi.org/10.1111/jocs.16840
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35971783
VL  - 37
ER  -
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