Key result
TA-TAVI is linked to better LVEF recovery versus C-AVR.
Why the study?
Differences in left ventricular recovery after transapical transcatheter aortic valve implantation versus conventional aortic valve replacement in patients with aortic regurgitation and reduced LVEF needed evaluation.
Does transapical transcatheter aortic valve implantation improve left ventricular recovery compared to conventional aortic valve replacement in patients with aortic regurgitation and reduced ejection fraction?
Cohort (n=87)
No
Does transapical transcatheter aortic valve implantation improve left ventricular recovery compared to conventional aortic valve replacement in patients with aortic regurgitation and reduced ejection fraction?
Effect estimate: adjusted β 0.002 (95% CI 0.000 to 0.003)
p-value: p=0.046
In patients with aortic regurgitation and reduced LVEF, transapical TAVI may offer faster and better early left ventricular recovery compared to conventional AVR.
May support transapical TAVI for early LVEF recovery in AR with reduced EF; leaves open need for randomized confirmation.
Background and Aim of the Study . To evaluate differences in left ventricular recovery after transapical transcatheter aortic valve implantation and conventional aortic valve replacement in patients with aortic regurgitation and reduced left ventricular ejection fraction. Methods . All patients with reduced left ventricular ejection fraction who underwent aortic valve surgery for AR at our institution between January 2015 and November 2021 were retrospectively reviewed. Generalized estimating equations were used to compare left ventricular recovery and remodeling outcomes between the patient groups. Results . A total of 87 cases were included in this study, 36 patients for TA‐TAVI and 51 patients for C‐AVR. Transapical transcatheter aortic valve implantation was associated with better and faster recovery of left ventricular ejection fraction and left ventricular end‐diastolic dimension (adjusted β = 0.002, 95% CI: 0.000 to 0.003, and p = 0.046; adjusted β = 0.330, 95% CI: 0.185 to 0.474, and p < 0.001, respectively) within the first 3 months postoperatively compared with left ventricular ejection fraction, with the same improvement in New York Heart Association function class (adjusted β = 0.381, 95% CI: −0.349 to 1.111, and p = 0.306). Conclusions . This study highlights patients who underwent transapical transcatheter aortic valve implantation for aortic regurgitation with reduced left ventricular ejection fraction. However, future randomized controlled prospective clinical trials with longer follow‐up durations are required.
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Lin et al. (2023) conducted a cohort in Aortic regurgitation with reduced left ventricular ejection fraction (n=87). Transapical transcatheter aortic valve implantation (TA-TAVI) vs. Conventional aortic valve replacement (C-AVR) was evaluated on Recovery of left ventricular ejection fraction (adjusted β 0.002, 95% CI 0.000 to 0.003, p=0.046). Transapical transcatheter aortic valve implantation was associated with better recovery of left ventricular ejection fraction (adjusted β 0.002; 95% CI 0.000-0.003; p=0.046) compared to conventional AVR.
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