Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Aug 2018
Review Meta AnalysisLong-term survival after transcatheter versus surgical aortic valve replacement for aortic stenosis: A meta-analysis of observational comparative studies with a propensity-score analysis.
To synthesize evidence regarding long-term survival after transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) for severe aortic stenosis (AS) from real-world clinical practice, we performed a meta-analysis of observational studies with a propensity-score analysis and ≥3-year follow-up. ⋯ On the basis of a meta-analysis of 14 observational comparative studies with a propensity-score analysis including a total of ≥4,000 patients, TAVI is associated with worse ≥3-year overall survival than SAVR.
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Catheter Cardiovasc Interv · Aug 2018
Meta AnalysisTranscatheter versus surgical aortic valve replacement in patients at low surgical risk: A meta-analysis of randomized trials and propensity score matched observational studies.
Although transcatheter aortic valve replacement (TAVR) is officially indicated for high risk aortic stenosis (AS) patients, the procedure is increasingly being performed in patients who are not at high surgical risk, including a substantial number of low risk patients. However, data on the benefit of TAVR in this patient population is limited. ⋯ In patients who are at low surgical risk, TAVR seems to be associated with increased mortality risk. Until more data in this population is available, SAVR should remain the treatment of choice for these patients.
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Catheter Cardiovasc Interv · May 2018
Review Meta AnalysisThoracic endovascular repair versus medical management for acute uncomplicated type B aortic dissection.
Current treatment options and outcomes for acute uncomplicated thoracic Type-B aortic dissection (TBAD) remain unclear between medical management (MED) and thoracic endovascular aortic repair (TEVAR). In this study we aim to compare both strategies in terms of all-cause mortality, aortic dilation, and aortic rupture. ⋯ There were no short, intermediate, or mid-term differences in mortality between TEVAR or MED in patients with acute uncomplicated TBAD. Although the dilation rate was similar between both groups, TEVAR was associated with lower likelihood of aortic rupture at 1 year.
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Catheter Cardiovasc Interv · Feb 2018
Meta AnalysisComparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta-analysis.
Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. ⋯ Our meta-analysis suggests that use of LA for TAVR is associated with a lower 30-day mortality, shorter procedure time, fluoroscopy time, ICU LOS, hospital length of stay, and reduced need for inotropic support.
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Catheter Cardiovasc Interv · Sep 2017
Review Meta AnalysisTranscatheter versus surgical aortic valve replacement in intermediate-risk patients: Evidence from a meta-analysis.
We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. ⋯ Our analysis of mid-term results showed that TAVR has similar clinical efficacy to SAVR in intermediate-risk patients with severe AS, and can be a suitable alternative to surgical valve replacement. © 2017 Wiley Periodicals, Inc.