Impact of left ventricular outflow tract calcification in patients undergoing transfemoral transcatheter aortic valve implantation

Impact of left ventricle outflow tract calcification on the outcomes of transcatheter aortic valve implantation: A study‐level meta‐analysis

“…Although we did our best to collect all the data available to carry out pooled analyses, the observational studies included in this meta‐analysis had nonnegligible differences between them, which may have affected these results. For example, five studies reported their results with a mix of THVs 15‐17,19,20 . and four studies reported their results exclusively with balloon‐expandable THVs 18,21–23 …”

“…Eight studies [15][16][17][18][19][20]22,23 reported their operative mortality rates (Figure 4). We observed that the pooled risk of operative death was higher in the group with significant LVOT calcification (OR: 2.28; 95% CI: 1.33-3.91; p < .001; Figure 4A) in comparison with the group without significant LVOT calcification.…”

“…Figure 5 depicts the pooled Kaplan-Meier curve for 1-year survival. Data from five studies 15,17,19,20,22 with a median follow-up of 11.9 months (interquartile range: 10.9-12.0) were pooled. Estimated 12-month survival was 83.3% (95% CI: 80.9%-85.8%) in the 991 patients with LVOT calcification compared to 88.6% (95% CI: 87.4%-89.9%) in the 2603 patients without LVOT calcification (hazard ratio: 1.53, 95% CI: 1.26-1.87, p < .001).…”

“…For example, five studies reported their results with a mix of THVs. [15][16][17]19,20 and four studies reported their results exclusively with balloon-expandable THVs. 18,[21][22][23] We should also bear in mind that the populations in the studies are of advanced age (over 80 years) and it is highly likely that some overlap with the factor "frailty" not captured in the studies is present.…”

“…After excluding duplicates and noneligible studies, nine studies [15][16][17][18][19][20][21][22][23] met our eligibility criteria (Figure 1). All studies were nonrandomized and observational, being five studies prospective and two studies multicentric (Table 1).…”