Key result
Transcatheter aortic valve replacement demonstrated acceptable safety and efficacy in Asian patients with pure native aortic regurgitation, with a pooled 30-day all-cause mortality rate of 2.8% and an overall device success rate of 94.9%.
Why the study?
Although SAVR is recommended for native AR without aortic stenosis, a significant proportion of Asian patients undergo TAVR, which has not been fully studied for safety and outcomes.
Does transcatheter aortic valve replacement improve outcomes in Asian patients with pure native aortic regurgitation?
Systematic Review (n=274)
Does transcatheter aortic valve replacement improve outcomes in Asian patients with pure native aortic regurgitation?
TAVR demonstrates acceptable safety and efficacy in Asian patients with pure native aortic regurgitation, with a pooled device success rate of 94.9% and low rates of mortality and complications.
May support TAVR consideration in high-risk Asian patients with pure native AR; extends observational evidence but leaves open need for RCTs.
AIMS: Although surgical aortic valve replacement (SAVR) is currently the recommended intervention for patients with native AR without aortic stenosis, a significant proportion of Asian patients undergo transcatheter aortic valve replacement (TAVR), which has not been studied fully for safety and outcomes. This systematic review aims to examine the characteristics and outcomes of Asian patients with pure native aortic regurgitation (AR) undergoing TAVR. METHODS AND RESULTS: PubMed, Embase, Scopus, Web of Science and Cochrane CENTRAL were systematically searched for randomised controlled trials, observational studies and case reports published from inception to 2 April 2020, involving patients of Asian ethnicity with pure native aortic regurgitation who had undergone TAVR. Our primary outcome was all-cause mortality, with secondary outcomes including all major complications. Five studies (n=274 patients) and eight case reports were included. Device success was reported in 94.9% of the patients, the all-cause mortality rate was 4.4%, 2.5% were converted to SAVR, 1.7% had post-operative paravalvular leak and 6.7% required permanent pacemaker implantation. CONCLUSIONS: TAVR has demonstrated acceptable safety and efficacy in Asian patients with pure AR displaying low mortality rates and few adverse outcomes.
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A 2021 study conducted a systematic review in Pure native aortic regurgitation (n=274). Transcatheter aortic valve replacement (TAVR) was evaluated on 30-day all-cause mortality (95% CI 0.2-5.4). Transcatheter aortic valve replacement demonstrated acceptable safety and efficacy in Asian patients with pure native aortic regurgitation, with a pooled 30-day all-cause mortality rate of 2.8% and an overall device success rate of 94.9%.
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