Universität zu Köln

Ashauer, Jannik Ole, Bonaros, Nikolaos, Kofler, Markus ORCID: 0000-0001-6932-7157, Schymik, Gerhard, Butter, Christian, Romano, Mauro, Bapat, Vinayak, Strauch, Justus, Schroefel, Holger, Busjahn, Andreas, Deutsch, Cornelia, Bramlage, Peter, Kurucova, Jana, Thoenes, Martin, Baldus, Stephan and Rudolph, Tanja K. (2019). Balloon-expandable transcatheter aortic valve implantation with or without pre-dilation - results of a meta-analysis of 3 multicenter registries. BMC Cardiovasc. Disord., 19. LONDON: BMC. ISSN 1471-2261

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Abstract

Background: To evaluate the outcomes of transcatheter aortic valve implantation (TAVI) without balloon aortic valvuloplasty (BAV) in a real-world setting through a patient-level meta-analysis. Methods: The meta-analysis included patients of three European multicenter, prospective, observational registry studies that compared outcomes after Edwards SAPIEN 3 or XT TAVI with (n=339) or without (n=355) BAV. Unadjusted and adjusted pooled odds ratios (with 95% confidence intervals) were calculated for procedural and 30-day outcomes. Results: Median procedural time was shorter in the non-BAV group than in the BAV group (73 versus 93 min, p=0.001), as was median fluoroscopy time (7 versus 11 min, p=0.001). Post-delivery balloon dilation (15.5% versus 22.4%, p=0.02) and catecholamine use (9.0% vs. 17.9%; p=0.016) was required less often in the non-BAV group than in the BAV group with the difference becoming insignificant after multiple adjustment. There was a reduced risk for periprocedural atrioventricular block during the intervention (1.4% versus 4.1%, p=0.035) which was non-significant after adjustment. The rate of moderate/severe paravalvular regurgitation post-TAVI was 0.6% in the no-BAV group versus 2.7% in the BAV group. There were no between-group differences in the risk of death, stroke or other adverse clinical outcomes at day 30. Conclusions: This patient-level meta-analysis of real-world data indicates that TAVI performed without BAV is advantageous as it has an adequate device success rate, reduced procedure time and no adverse effects on short-term clinical outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ashauer, Jannik Ole UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonaros, Nikolaos UNSPECIFIED UNSPECIFIED UNSPECIFIED Kofler, Markus UNSPECIFIED orcid.org/0000-0001-6932-7157 UNSPECIFIED Schymik, Gerhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Butter, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Romano, Mauro UNSPECIFIED UNSPECIFIED UNSPECIFIED Bapat, Vinayak UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauch, Justus UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroefel, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Busjahn, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Deutsch, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Bramlage, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurucova, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Thoenes, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134949
DOI:	10.1186/s12872-019-1151-y
Journal or Publication Title:	BMC Cardiovasc. Disord.
Volume:	19
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2261
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VALVULOPLASTY; FEASIBILITY; PREDILATION; RATIONALE; DESIGN Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13494