Reduced inflammatory response by transcatheter, as compared to surgical aortic valve replacement
Key result
Transcatheter aortic valve implantation resulted in significantly lower activation of complement, granulocytes, monocytes, and eosinophils compared to surgical replacement (P<0.01).
Why the study?
Does TAVI reduce the inflammatory response compared to SAVR in patients undergoing aortic valve replacement?
Population
36 patients undergoing aortic valve replacement
Comparison
Transcatheter aortic valve implantation vs Surgical aortic valve replacement (SAVR) (n=18)
Design
Cohort
Follow-up
per- and postoperatively
Authors
Discussion
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Implication
TAVI linked to lower inflammatory activation than SAVR; leaves open impact on outcomes and need for randomized confirmation.
Study Design
Type
RCT (n=36)
Structured PICO
Does TAVI reduce the inflammatory response compared to SAVR in patients undergoing aortic valve replacement?
P
Population
36 patients undergoing either transcatheter or surgical aortic valve replacement, evaluated for per- and postoperative inflammatory response.
I
Intervention
Transcatheter aortic valve implantation (TAVI) (transfemoral n=9 or transaortal n=9)
C
Comparator
Surgical aortic valve replacement (SAVR) (n=18)
O
Outcome
Inflammatory response (C3bc, terminal complement complex, myeloperoxidase, macrophage inflammatory protein-1β, monocyte chemo-attractant peptide-1, eotaxin, IL-6 and troponin-T) measured by area under the curvesurrogate
Main Result
p-value: p=<0.01
TAVI is associated with a significantly lower systemic inflammatory response compared to SAVR, though myocardial injury markers (troponin T) and IL-6 are similar.
Cite This Study
Fiane et al. (2017) conducted an RCT in Aortic valve disease requiring replacement (n=36). Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement (SAVR) was evaluated on Inflammatory response (areas under the curve for inflammatory markers including complement, granulocytes, monocytes, and eosinophils) (p=<0.01). Transcatheter aortic valve implantation resulted in significantly lower activation of complement, granulocytes, monocytes, and eosinophils compared to surgical replacement (P<0.01).