Transcatheter aortic valve implantation versus surgical aortic valve replacement in dialysis-dependent patients: a meta-analysis

Samuel Burton; Alexander Reynolds; Nicola King; Amit Modi; Sanjay Asopa

doi:10.2459/jcm.0000000000001495

Transcatheter aortic valve implantation versus surgical aortic valve replacement in dialysis-dependent patients: a meta-analysis

Samuel Burton^*, Alexander Reynolds, Nicola King, Amit Modi, Sanjay Asopa

^*Corresponding author for this work

School of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

3 Downloads (Pure)

Abstract

Objectives This meta-analysis aims to compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) versus aortic valve replacement (AVR) for aortic stenosis in dialysis-dependent patients. Methods Literature searches employed PubMed, Web of Science, Google Scholar and Embase to identify relevant studies. Bias-treated data were prioritized, isolated and pooled for analysis; raw data were utilized where bias-treated data were unavailable. Outcomes were analysed to assess for study data crossover. Results Literature search identified 10 retrospective studies; following data source analysis, five studies were included. Upon pooling of bias-treated data, TAVI was significantly favoured in early mortality [odds ratio (OR), 0.42; 95% confidence interval (95% CI), 0.19–0.92; I 2 = 92%; P = 0.03], 1-year mortality (OR, 0.88; 95% CI 0.80–0.97; I 2 = 0%; P = 0.01), rates of stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55–0.93; I 2 = 0%; P = 0.01) and blood transfusions (OR, 0.36; 95% CI 0.21–0.62; I 2 = 86%; P = 0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR group (OR, 3.33; 95% CI 1.94–5.73; I 2 = 74%; P ≤ 0.0001) and no difference in the rate of vascular complications (OR, 2.27; 95% CI 0.60–8.59; I 2 = 83%; P = 0.23). Analysis including raw data revealed the length of hospital stay to favour TAVI with a mean difference of –9.20 days (95% CI –15.58 to –2.82; I 2 = 97%; P = 0.005). Conclusion Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI in early mortality, 1-year mortality, rates of stroke/cerebrovascular events and blood transfusions. There was no difference in the rates of vascular complications; however, TAVI required more pacemaker implantations. Data pooling including raw data revealed that the length of hospital admission favours TAVI.

Original language	English
Pages (from-to)	666-673
Number of pages	0
Journal	Journal of Cardiovascular Medicine
Volume	24
Issue number	9
Early online date	Sept 2023
DOIs	https://doi.org/10.2459/jcm.0000000000001495
Publication status	Published - Sept 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.2459/jcm.0000000000001495

Burton et al 2023

Cite this

@article{8595da6f0c8b4e22a48afda399b158db,

title = "Transcatheter aortic valve implantation versus surgical aortic valve replacement in dialysis-dependent patients: a meta-analysis",

abstract = " Objectives This meta-analysis aims to compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) versus aortic valve replacement (AVR) for aortic stenosis in dialysis-dependent patients. Methods Literature searches employed PubMed, Web of Science, Google Scholar and Embase to identify relevant studies. Bias-treated data were prioritized, isolated and pooled for analysis; raw data were utilized where bias-treated data were unavailable. Outcomes were analysed to assess for study data crossover. Results Literature search identified 10 retrospective studies; following data source analysis, five studies were included. Upon pooling of bias-treated data, TAVI was significantly favoured in early mortality [odds ratio (OR), 0.42; 95% confidence interval (95% CI), 0.19–0.92; I 2 = 92%; P = 0.03], 1-year mortality (OR, 0.88; 95% CI 0.80–0.97; I 2 = 0%; P = 0.01), rates of stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55–0.93; I 2 = 0%; P = 0.01) and blood transfusions (OR, 0.36; 95% CI 0.21–0.62; I 2 = 86%; P = 0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR group (OR, 3.33; 95% CI 1.94–5.73; I 2 = 74%; P ≤ 0.0001) and no difference in the rate of vascular complications (OR, 2.27; 95% CI 0.60–8.59; I 2 = 83%; P = 0.23). Analysis including raw data revealed the length of hospital stay to favour TAVI with a mean difference of –9.20 days (95% CI –15.58 to –2.82; I 2 = 97%; P = 0.005). Conclusion Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI in early mortality, 1-year mortality, rates of stroke/cerebrovascular events and blood transfusions. There was no difference in the rates of vascular complications; however, TAVI required more pacemaker implantations. Data pooling including raw data revealed that the length of hospital admission favours TAVI. ",

author = "Samuel Burton and Alexander Reynolds and Nicola King and Amit Modi and Sanjay Asopa",

year = "2023",

month = sep,

doi = "10.2459/jcm.0000000000001495",

language = "English",

volume = "24",

pages = "666--673",

journal = "Journal of Cardiovascular Medicine",

issn = "1558-2027",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "9",

}

TY - JOUR

T1 - Transcatheter aortic valve implantation versus surgical aortic valve replacement in dialysis-dependent patients: a meta-analysis

AU - Burton, Samuel

AU - Reynolds, Alexander

AU - King, Nicola

AU - Modi, Amit

AU - Asopa, Sanjay

PY - 2023/9

Y1 - 2023/9

N2 - Objectives This meta-analysis aims to compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) versus aortic valve replacement (AVR) for aortic stenosis in dialysis-dependent patients. Methods Literature searches employed PubMed, Web of Science, Google Scholar and Embase to identify relevant studies. Bias-treated data were prioritized, isolated and pooled for analysis; raw data were utilized where bias-treated data were unavailable. Outcomes were analysed to assess for study data crossover. Results Literature search identified 10 retrospective studies; following data source analysis, five studies were included. Upon pooling of bias-treated data, TAVI was significantly favoured in early mortality [odds ratio (OR), 0.42; 95% confidence interval (95% CI), 0.19–0.92; I 2 = 92%; P = 0.03], 1-year mortality (OR, 0.88; 95% CI 0.80–0.97; I 2 = 0%; P = 0.01), rates of stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55–0.93; I 2 = 0%; P = 0.01) and blood transfusions (OR, 0.36; 95% CI 0.21–0.62; I 2 = 86%; P = 0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR group (OR, 3.33; 95% CI 1.94–5.73; I 2 = 74%; P ≤ 0.0001) and no difference in the rate of vascular complications (OR, 2.27; 95% CI 0.60–8.59; I 2 = 83%; P = 0.23). Analysis including raw data revealed the length of hospital stay to favour TAVI with a mean difference of –9.20 days (95% CI –15.58 to –2.82; I 2 = 97%; P = 0.005). Conclusion Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI in early mortality, 1-year mortality, rates of stroke/cerebrovascular events and blood transfusions. There was no difference in the rates of vascular complications; however, TAVI required more pacemaker implantations. Data pooling including raw data revealed that the length of hospital admission favours TAVI.

AB - Objectives This meta-analysis aims to compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) versus aortic valve replacement (AVR) for aortic stenosis in dialysis-dependent patients. Methods Literature searches employed PubMed, Web of Science, Google Scholar and Embase to identify relevant studies. Bias-treated data were prioritized, isolated and pooled for analysis; raw data were utilized where bias-treated data were unavailable. Outcomes were analysed to assess for study data crossover. Results Literature search identified 10 retrospective studies; following data source analysis, five studies were included. Upon pooling of bias-treated data, TAVI was significantly favoured in early mortality [odds ratio (OR), 0.42; 95% confidence interval (95% CI), 0.19–0.92; I 2 = 92%; P = 0.03], 1-year mortality (OR, 0.88; 95% CI 0.80–0.97; I 2 = 0%; P = 0.01), rates of stroke/cerebrovascular events (OR, 0.71; 95% CI 0.55–0.93; I 2 = 0%; P = 0.01) and blood transfusions (OR, 0.36; 95% CI 0.21–0.62; I 2 = 86%; P = 0.0002). Pooling demonstrated fewer new pacemaker implantations in the AVR group (OR, 3.33; 95% CI 1.94–5.73; I 2 = 74%; P ≤ 0.0001) and no difference in the rate of vascular complications (OR, 2.27; 95% CI 0.60–8.59; I 2 = 83%; P = 0.23). Analysis including raw data revealed the length of hospital stay to favour TAVI with a mean difference of –9.20 days (95% CI –15.58 to –2.82; I 2 = 97%; P = 0.005). Conclusion Bias-treated meta-analysis comparing surgical AVR and TAVI favoured TAVI in early mortality, 1-year mortality, rates of stroke/cerebrovascular events and blood transfusions. There was no difference in the rates of vascular complications; however, TAVI required more pacemaker implantations. Data pooling including raw data revealed that the length of hospital admission favours TAVI.

U2 - 10.2459/jcm.0000000000001495

DO - 10.2459/jcm.0000000000001495

M3 - Article

SN - 1558-2027

VL - 24

SP - 666

EP - 673

JO - Journal of Cardiovascular Medicine

JF - Journal of Cardiovascular Medicine

IS - 9

ER -

Transcatheter aortic valve implantation versus surgical aortic valve replacement in dialysis-dependent patients: a meta-analysis

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this