Transcatheter aortic valve replacement (TAVR) was favored over surgical replacement for preserving right ventricular systolic function, measured by TAPSE (g=2.88, P<0.001).
Meta-Analysis (n=485)
Yes
Does transcatheter aortic valve replacement (TAVR) improve or preserve right ventricular systolic function compared to surgical aortic valve replacement (SAVR) in high-risk patients with severe aortic stenosis?
In high-risk patients with severe aortic stenosis, TAVR preserves right ventricular systolic function better than SAVR, which is associated with a negative effect on right ventricular function.
Effect estimate: Hedges' g 2.88 for TAPSE; g 0.91 for RVFAC
p-value: p=<0.001
Objectives: We ought to compare the effect of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) on right ventricular systolic function (RVSF) in high risk patients with severe aortic stenosis (AS). Methodology: Data source: PubMed, EMBASE, Cochrane library, and references of selected articles. Study Endpoints: Transthoracic echocardiography was utilized to assess the change in RVSF post TAVR versus SAVR using tricuspid annular plane systolic excursion (TAPSE), and fractional area change (RVFAC). Statistical analyses: Random effect model on standardized mean difference (Hedges; g) were used together with heterogeneity assessment. Result: We included 485 patients from five single-center observational studies. TAVR had no effect while SAVR had negative effect on RVSF, and the effect was in favor of TAVR when TAVR compared to SAVR TAPSE (g=2.88, SE=0.63, P<0.001, Q=73.18, I2=94.53, r=0.65), and RVFAC (g=0.91, SE=0.16, P<0.001, Q=2.39, I2=16.61), r=0.65. Conclusion: Compared with SAVR, TAVR is preferred aortic intervention for patients with severe symptomatic AS and RV systolic dysfunction.
Zahaf et al. (Fri,) conducted a meta-analysis in Severe aortic stenosis (n=485). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Change in right ventricular systolic function (RVSF) using tricuspid annular plane systolic excursion (TAPSE) and fractional area change (RVFAC) (Hedges' g 2.88 for TAPSE; g 0.91 for RVFAC, p=<0.001). Transcatheter aortic valve replacement (TAVR) was favored over surgical replacement for preserving right ventricular systolic function, measured by TAPSE (g=2.88, P<0.001).