Key result
Bicuspid TAVI matches tricuspid mortality but carries ~24% higher stroke risk, increased PVL, and pacemaker need.
Why the study?
The safety and efficacy of TAVI for aortic stenosis in bicuspid aortic valve compared to tricuspid aortic valve remains controversial.
Does TAVI in bicuspid aortic valve compared to tricuspid aortic valve have similar safety and efficacy in patients with aortic stenosis?
Meta-Analysis (n=189,693)
Does TAVI in bicuspid aortic valve compared to tricuspid aortic valve have similar safety and efficacy in patients with aortic stenosis?
TAVI for bicuspid aortic stenosis is generally safe and effective with similar mortality to tricuspid aortic stenosis, though associated with slightly higher risks of stroke, paravalvular leak, and pacemaker implantation.
Supports TAVI in bicuspid AS with equivalent mortality; extends evidence by quantifying higher stroke, leak, and pacemaker risks.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective alternative to surgical replacement for tricuspid aortic valve (TAV) stenosis. However, utilization of TAVI for aortic stenosis in bicuspid aortic valve (BAV) compared to TAV remains controversial. METHODS: We queried online databases with various keywords to identify relevant articles. We compared major cardiovascular events and procedural outcomes using a random effect model to calculate odds ratios (OR). RESULTS: We included a total of 22 studies comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled analysis, there were no difference in TAVI for BAV vs. TAV for all-cause mortality, cardiovascular mortality, myocardial infarction (MI), vascular complications, acute kidney injury (AKI), coronary occlusion, annulus rupture, and reintervention/reoperation between the groups. The incidence of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42; 95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26) was less in the TAV group compared to the BAV group, while incidence of life-threatening bleeding was higher in the TAV group. Subgroup analysis mirrored pooled outcomes except for all-cause mortality. CONCLUSION: The use of TAVI for the treatment of aortic stenosis in selective BAV appears to be safe and effective.
No takes yet. Share an insight, caveat, or question.
Zghouzi et al. (2022) conducted a meta-analysis in Aortic stenosis (n=189,693). Transcatheter aortic valve implantation in bicuspid aortic valve vs. Transcatheter aortic valve implantation in tricuspid aortic valve was evaluated on Major cardiovascular events and procedural outcomes. TAVI for bicuspid aortic stenosis showed no difference in mortality compared to tricuspid valves, but had higher rates of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak, and pacemaker need.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: