What question did this study set out to answer?

To identify factors associated with the elevated mortality and morbidity observed during surgical explantation of transcatheter aortic valves.

February 23, 2024Journal of Clinical MedicineOpen Access

Valve Type and Operative Risks in Surgical Explantation of Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis

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Why the study?

Surgical explantation of TAVR is increasingly frequent, but factors contributing to the high mortality and morbidity of these procedures needed to be identified.

Does the type of transcatheter valve implanted during the index procedure influence mortality and morbidity after surgical explantation of TAVR?

Comparison

Type of transcatheter valve implanted during index procedure

Design

Systematic review and meta-analysis with metaregression

Follow-up

30-day

Authors

RARiccardo AbbascianoInterventional / Structural Cardiology DMDimitrios E. MagouliotisCardiac Surgery MKMarinos KoulouroudiasNottingham University Hospitals NHS Trust

Discussion

Member takes

Implication

TAVR explantation carries high 30-day mortality and morbidity regardless of valve type; confirms explant risks are device-independent and informs shared decision-making.

Key Points

To identify factors associated with the elevated mortality and morbidity observed during surgical explantation of transcatheter aortic valves.
Systematic search of MEDLINE and Embase identified 12 eligible studies investigating transcatheter aortic valve replacement (TAVR) surgical explantation.
Meta-analysis and metaregression were conducted to assess 30-day mortality, morbidity, and the impact of the index transcatheter valve type.
Surgical explantation of TAVR was associated with a 30-day mortality rate of 0.17 (95% CI, 0.14-0.21).
Postoperative morbidity included a stroke incidence of 5% (95% CI, 0.04-0.07) and a kidney injury incidence of 16% (95% CI, 0.11-0.24).
The specific type of transcatheter valve implanted during the index procedure did not influence clinical outcomes after surgical explantation.

Structured PICO

Does the type of transcatheter valve implanted during the index procedure influence mortality and morbidity after surgical explantation of TAVR?

Population

Patients undergoing surgical explantation of transcatheter aortic valves (TAVR) across 12 pooled studies.

Intervention

Surgical explantation of transcatheter aortic valves (TAVR)

Comparator

Different types of transcatheter valves implanted during the index procedure

Outcome

30-day mortality and morbidity (stroke and kidney injury)hard clinical

Surgical explantation of TAVR is a high-risk procedure with significant 30-day mortality and morbidity, regardless of the type of transcatheter valve originally implanted.

Cite This Study

Abbasciano et al. (2024) studied this question.

synapsesocial.com/papers/69d814a452654bb436d17c70 https://doi.org/10.3390/jcm13051262

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Implication

TAVR explantation carries high 30-day mortality and morbidity regardless of valve type; confirms explant risks are device-independent and informs shared decision-making.

Valve Type and Operative Risks in Surgical Explantation of Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Valve Type and Operative Risks in Surgical Explantation of Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider