Cardiovascular Outcomes of Older versus Newer Generation Transcatheter Aortic Valve Replacement Recipients: A Systematic Review &amp; Meta-analysis

Sattar, Yasar; Prakash, Preeya; Almas, Talal; Mir, Tanveer; Titus, Anoop; Ahmad, Shahzad; Khan, Muhammad Zubair; Aggarwal, Ankita; Ullah, Waqas; Alhharbi, Anas; Kakouros, Nikolaos; Alraies, M. Chadi; Qureshi, Waqas

doi:10.1016/j.cpcardiol.2022.101467

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…The introduction of the new generation THVs, including Sapien 3, Corevalve Evolut R, and Evolut Pro, has advanced the TAVR technology and additionally reinforced procedural safety. A recent systematic review and meta-analysis of 14 studies comparing the older and newer generation THVs indicated that the newer generation THVs had better clinical efficacy and fewer postprocedural complications directly compared to the older generation THVs, including major vascular complications, major bleeding, significant PVL, acute kidney injury, and all-cause mortality [ 8 ]. However, there were no statistically significant differences in stroke, acute myocardial infarction, and new permanent pacemaker implantation between the older and newer generation THVs.…”

Section: Discussionmentioning

confidence: 99%

“…Since the development of the newer generation THVs such as Edwards Sapien 3, Medtronic Corevalve Evolut R, and Medtronic Evolut Pro, there have been decreased risks of procedural-related complications including vascular complications, bleeding, paravalvular leak (PVL), acute kidney injury, and mortality [ 8 ]. However, despite the advancement and better safety profile of the new generation THVs, it is unclear whether differences in outcomes between genders persist with newer generation THVs.…”

Section: Introductionmentioning

confidence: 99%

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Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis

et al. 2023

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Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs. We aim to assess gender disparities after TAVR with newer generation THVs. The MEDLINE and Embase databases were thoroughly searched from inception to April 2023 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). The outcomes of interest included 30-day mortality, 1-year mortality, and vascular complications. In total, 5 studies (4 databases) with a total of 47,933 patients (21,073 females and 26,860 males) were included. Ninety-six percent received TAVR via the transfemoral approach. The females had higher 30-day mortality rates (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.31–1.79, p-value (p) < 0.001) and vascular complications (OR = 1.43, 95% CI 1.23–1.65, p < 0.001). However, one-year mortality was similar between the two groups (OR = 0.78, 95% CI 0.61–1.00, p = 0.28). The female gender continues to be associated with higher 30-day mortality rates and vascular complications after TAVR with newer generation transcatheter heart valves, while there was no difference in 1-year mortality between the genders. More data is needed to explore the causes and whether we can improve TAVR outcomes in females.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis

et al. 2023

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“…One example is the rate of paravalvular regurgitation, which has important prognostic implications. However, sealing skirts on newer generation valves have significantly reduced the incidence of paravalvular regurgitation 23. Further advances in the procedure and management of TAVI patients are required in order to improve outcomes and minimise complications.…”

Section: Short-term Management Post-tavimentioning

confidence: 99%

Future of transcatheter aortic valve implantation: where do we go from here?

Patel

Baumbach

2023

Heart

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“…These iterations have focused on decreasing the profile of the sheaths to reduce vascular complications and bleeding, external skirts to mitigate paravalvular leak, in addition to more friendly delivery catheters, among other improvements. Collectively, these improvements, together with better patient assessment and refined techniques, have reduced the majority of the periprocedural complications and mortality (102,116).…”

Section: Discussionmentioning

confidence: 99%

“…have been shown to be consistently effective in treating severe aortic stenosis patients, with comparable clinical outcomes to SAVR (17,18,31,32,109,110). Newgeneration THV iterations have emerged for both types of prosthesis bringing several improvements with the goal of offering more reliable and safer procedures which has culminated in even better short-to mid-term clinical outcomes as compared to SAVR (102,111).…”

Section: Introductionmentioning

confidence: 99%

Impacto da curva de aprendizado e evolução das práticas de implante de válvula aórtica transcateter no Brasil e na América Latina

Bernardi

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I thank all the people and colleagues who directly or indirectly contributed to the realization of this thesis and the articles made through it. I would like to thank in particular my friend and advisor Prof. Dr. Henrique Barbosa Ribeiro, to whom I will be eternally grateful for the opportunity given to me and for all the knowledge I gained. "Those who pass by us don't go alone, they don't leave us alone. They leave a little of themselves, they take a little of us."(Antoine de Saint-Exupéry) vi "This is a historic moment, and all of us here should remember it as such. We will talk to our grandchildren about thisthat we were here at the time this incredible advance in the care of patients with aortic stenosis was presented."

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Cardiovascular Outcomes of Older versus Newer Generation Transcatheter Aortic Valve Replacement Recipients: A Systematic Review & Meta-analysis

Cited by 8 publications

References 21 publications

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis

Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis

Future of transcatheter aortic valve implantation: where do we go from here?

Impacto da curva de aprendizado e evolução das práticas de implante de válvula aórtica transcateter no Brasil e na América Latina

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