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Balloon-expandable, self-expanding valves comparable for TAVI

14 Oct 2019
In intermediate risk patients, the TAVR is found to have better outcomes

Transcatheter aortic valve implantation (TAVI) with either balloon-expandable valves (BEVs) or self-expanding valves (SEVs) yields comparable outcomes, according to a new meta-analysis.

Accessing the databases of PubMed, the Cochrane Library and Embase through 31 March 2019, researchers retrieved eight randomized controlled trials for inclusion in the Bayesian network meta-analysis. The primary outcome of interest was all-cause mortality at the latest follow-up, while secondary outcomes included long-term cardiovascular mortality, stroke, pacemaker implantation, among other vascular events.

The pooled sample included 8,095 patients, of whom 1,976, 2,256 and 3,863 received BEV, SEV and surgical aortic valve replacement, respectively.

Researchers detected no significant difference between BEV and SEV in terms of 30-day all-cause mortality (odds ratio [OR], 0.85, 95 percent CI, 0.34–1.99), cardiovascular mortality (OR, 1.3, 0.58–2.50), stroke (OR, 1.59, 0.37–6.71), bleeding (OR, 0.85, 0.34–1.99) and major vascular complications (OR, 1.30, 0.58–2.50).

Both interventions were likewise comparable for short-term, 30-day moderate to severe paravalvular leak (OR, 0.28, 0.06–1.22).

Long-term outcomes were also similar between BEV and SEV: all-cause mortality (hazard ratio [HR], 1.1, 0.87–1.5), cardiovascular mortality (HR, 1.1, 0.73–1.6), stroke (HR, 1.3, 0.73–2.1), hospitalization (HR, 0.87, 0.41–1.6) and reintervention (HR, 0.68, 0.2–2.3).

Only the difference in the need for new pacemaker reimplantation, both in the short-term (OR, 0.29, 0.11–0.77) and long-term (HR, 0.45, 0.24–0.80) achieved statistical significance, such that BEV patients were less likely to require it.

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Most Read Articles
Stephen Padilla, 06 Aug 2020
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
06 Aug 2020
Sodium–glucose cotransporter-2 (SGLT-2) inhibitors increase the risk for diabetic ketoacidosis (DKA) by almost threefold, with molecule-specific analyses suggesting a class effect, according to a study.
Stephen Padilla, 3 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.