Transcatheter aortic valve replacement (TAVR) mortality is evenly balanced, with noncardiovascular causes accounting for 46.4% and 51.6% of deaths within and after 30 days, respectively.
Meta-Analysis
What are the specific causes of death within and after 30 days following TAVR?
Cardiovascular and noncardiovascular causes of death are evenly balanced after TAVR, with infection/sepsis and heart failure being the most frequent causes both early and late post-procedure.
Background Transcatheter aortic valve replacement ( TAVR ) is an effective alternative to surgical aortic valve replacement in patients at high surgical risk. However, there is little published literature on the exact causes of death. Methods and Results The PubMed database was systematically searched for studies reporting causes of death within and after 30 days following TAVR . Twenty‐eight studies out of 3934 results retrieved were identified. In the overall analysis, 46.4% and 51.6% of deaths were related to noncardiovascular causes within and after the first 30 days, respectively. Within 30 days of TAVR , infection/sepsis (18.5%), heart failure (14.7%), and multiorgan failure (13.2%) were the top 3 causes of death. Beyond 30 days, infection/sepsis (14.3%), heart failure (14.1%), and sudden death (10.8%) were the most common causes. All possible subgroup analyses were made. No significant differences were seen for proportions of cardiovascular deaths except the comparison between moderate (mean STS score 4 to 8) and high (mean STS score >8) ‐risk patients after 30 days post‐ TAVR (56.0% versus 33.5%, P =0.005). Conclusions Cardiovascular and noncardiovascular causes of death are evenly balanced both in the perioperative period and at long‐term follow‐up after TAVR . Infection/sepsis and heart failure were the most frequent noncardiovascular and cardiovascular causes of death. This study highlights important areas of clinical focus that could further improve outcomes after TAVR .
Xiong et al. (Wed,) conducted a meta-analysis in High surgical risk patients requiring aortic valve replacement. Transcatheter aortic valve replacement (TAVR) was evaluated on Causes of death within and after 30 days following TAVR. Transcatheter aortic valve replacement (TAVR) mortality is evenly balanced, with noncardiovascular causes accounting for 46.4% and 51.6% of deaths within and after 30 days, respectively.