Key result
TAVR in the Middle East and North Africa achieved a 96.4% (95% CI, 95.8%-97.0%) pooled device success rate, with all-cause mortality of 13.7 per 100 person-years (95% CI, 12.9-14.6).
Why the study?
Data on transcatheter aortic valve replacement (TAVR) outcomes in the Middle East and North Africa region are limited.
Meta-Analysis (n=7,331)
Yes
In the Middle East and North Africa region, TAVR demonstrates a high device success rate (96.4%) and relatively low cardiovascular mortality (4.8 per 100 person-years), with permanent pacemaker implantation being the most common complication (10.0 per 100 person-years).
BACKGROUND: Data on transcatheter aortic valve replacement (TAVR) outcomes in the Middle East and North Africa region are limited. We synthesized available evidence on post-TAVR clinical outcomes in the Middle East and North Africa region. METHODS: We systematically searched PubMed, Embase, and Scopus from inception through May 2025 for studies reporting TAVR outcomes in this region. Outcomes included device success, all-cause death, cardiovascular death, myocardial infarction, stroke, new-onset atrial fibrillation, moderate to severe paravalvular leak, and permanent pacemaker implantation. Overall incidence rates were pooled via Poisson analysis and reported per 100 person-years with 95% CIs. RESULTS: Forty-eight studies encompassing 7331 patients (mean age, 76.9±8.5 years; 52.4% women) were included. Pooled device success rate was 96.4% (95% CI, 95.8%-97.0%). At latest follow-up, pooled incidence rates per 100 person-years were 13.7 for all-cause death (95% CI, 12.9-14.6), 4.8 for cardiovascular death (95% CI, 4.1-5.7), 1.0 for myocardial infarction (95% CI, 0.7-1.4), 1.6 for stroke (95% CI, 1.3-1.9), 2.7 for moderate to severe paravalvular leak (95% CI, 2.2-3.4), 6.5 for new-onset atrial fibrillation (95% CI, 5.5-7.7), and 10.0 for permanent pacemaker implantation (95% CI, 9.2-10.9). Post hoc exploratory meta-regression identified significant study-level modifying effects, with higher mean age and greater use of first-generation versus second-generation valves associated with higher overall all-cause mortality incidence following TAVR. Certainty of evidence was low or very low across all outcomes. CONCLUSIONS: TAVR in the Middle East and North Africa region was associated with high device success rate and relatively low cardiovascular death. Permanent pacemaker implantation was the most prevalent post-TAVR complication. Further studies are warranted to optimize TAVR practice in this region.
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Bastan et al. (2026) conducted a meta-analysis in Aortic valve disease undergoing transcatheter aortic valve replacement (TAVR) (n=7,331). Transcatheter aortic valve replacement (TAVR) was evaluated on Device success and all-cause death per 100 person-years (95% CI 95.8%-97.0%). TAVR in the Middle East and North Africa achieved a 96.4% (95% CI, 95.8%-97.0%) pooled device success rate, with all-cause mortality of 13.7 per 100 person-years (95% CI, 12.9-14.6).
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