TCT-501 Impact of TAVR Implantation Technique on Need for Permanent Pacemaker Implantation

Sadiq, Immad; Bakhsh, Muhammad; Memon, Sarfaraz; Ouranos, Hossein; Mahmaljy, Hadi; Gurung, Sidhanta; Hoover, Nicole; Rizvi, Asad; Hagberg, Robert; Azemi, Talhat

doi:10.1016/j.jacc.2021.09.1354

Cited by 2 publications

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“…After excluding duplicates and non-eligible studies, 11 studies [14][15][16][17][18][19][20][21][22][23][24] met our eligibility criteria (Figure 1). All the studies were nonrandomized, observational, mostly retrospective, and non-multicentric.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Cusp‐overlap versus coplanar view in transcatheter aortic valve implantation with self‐expandable valves: A meta‐analysis of comparative studies

Sá

Eynde

Jacquemyn

et al. 2023

Cathet Cardio Intervent

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Background Permanent pacemaker implantation (PPI) is a common complication after transcatheter aortic valve implantation (TAVI). The cusp‐overlap view (COV) was adopted to reduce PPI risk after TAVI with self‐expandable valves (SEVs); however, the evidence remains scarce. We performed a systematic review with meta‐analysis comparing COV and the standard coplanar view (CPV) technique to evaluate their effectiveness and safety. Methods Following the PRISMA statement, data were extracted from studies published by August 2022 and found in PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, http://ClinicalTrials.gov, SciELO, LILACS, and Google Scholar. The primary outcome of interest was post‐procedural PPI and the secondary outcomes were new left bundle branch block (LBBB), moderate/severe paravalvular leak (PVL), valve dislocation (pop‐out); need of second transcatheter heart valve, 30‐day mortality, stroke, conversion to surgery, coronary obstruction, implantation depth (mm), and post‐TAVI mean gradients (mmHg). Results Eleven studies met our eligibility criteria and included 1464 patients in the COV group and 1743 patients in the CPV group. Patients who underwent TAVI with COV had lower risk of PPI (odds ratio 0.48; 95% confidence interval [CI] 0.33–0.70; p = 0.001) and higher implantation depths with COV (mean difference −0.83; 95% CI −1.2 to −0.45; p < 0.001). We did not observe any statistically significant differences in the rates of new LBBB, moderate/severe PVL, valve dislocation, need of second transcatheter heart valve, 30‐day mortality, stroke, conversion to surgery, coronary obstruction, and post‐TAVI mean gradients (mmHg). Conclusion In TAVI with SEVs, the application of COV is associated with lower risk of PPI compared with the standard CPV without increasing risk for adverse outcomes.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Cusp‐overlap versus coplanar view in transcatheter aortic valve implantation with self‐expandable valves: A meta‐analysis of comparative studies

Sá

Eynde

Jacquemyn

et al. 2023

Cathet Cardio Intervent

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“…The flowchart of the literature search is presented in Figure 2. A total of 11 studies, including 3,647 patients, were finally included in this meta-analysis (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). All of the included studies were non-randomized cohort studies.…”

Section: Included Studies and Study Detailsmentioning

confidence: 99%

Comparison of cusp-overlap projection and standard three-cusp coplanar view during self-expanding transcatheter aortic valve replacement: A systematic review and meta-analysis

Chen

Zhu

Liu

et al. 2022

Front. Cardiovasc. Med.

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ObjectivePermanent pacemaker implantation (PPI) is a common complication after transcatheter aortic valve replacement (TAVR). Recently, the cusp-overlap projection (COP) technique was thought to be a feasible method to reduce PPI risk. However, the evidence is still relatively scarce. Therefore, this meta-analysis was performed to compare COP and standard three-cusp coplanar (TCC) projection technique.MethodsPubMed and EMBASE databases were systematically searched for relevant literature published from the inception (EMBASE from 1974 and PubMed from 1966) to 16 April 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome of interest was post-operative (including in-hospital and 30-day) PPI.ResultsTotal of 3,647 subjects from 11 studies were included in this meta-analysis. Of those, 1,453 underwent self-expanding TAVR using COP and 2,194 using TCC technique. In a pooled analysis, the cumulative PPI incidence was 9.3% [95% confidence interval (CI): 6.9–11.7%] and 18.9% (95% CI: 15.5–22.3%) in the COP group and TCC group, respectively. The application of the COP technique was associated with a significant PPI risk reduction (I2 = 40.3% and heterogeneity Chi-square p = 0.070, random-effects OR: 0.49, 95% CI: 0.36–0.66, p < 0.001). A higher implantation depth was achieved in the COP group compared with the TCC group [standardized mean difference (SMD) = −0.324, 95% CI: (−0.469, −0.180)]. There was no significant difference between the two groups in second valve implantation, prosthesis pop-out, fluoroscopic time, post-operative left bundle branch block, mortality, stroke, moderate/severe paravalvular leakage, mean gradient, and length of hospital stay. However, radiation doses were higher in the COP group [SMD = 0.394, 95% CI: (0.216, 0.572), p < 0.001].ConclusionIn self-expanding TAVR, the application of the cusp overlap projection technique was associated with a lower risk of PPI compared with the standard TCC technique.Systematic review registration[https://inplasy.com/inplasy-2022-4-0092/], identifier [INPLASY202240092].

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TCT-501 Impact of TAVR Implantation Technique on Need for Permanent Pacemaker Implantation

Cited by 2 publications

References 0 publications

Cusp‐overlap versus coplanar view in transcatheter aortic valve implantation with self‐expandable valves: A meta‐analysis of comparative studies

Cusp‐overlap versus coplanar view in transcatheter aortic valve implantation with self‐expandable valves: A meta‐analysis of comparative studies

Comparison of cusp-overlap projection and standard three-cusp coplanar view during self-expanding transcatheter aortic valve replacement: A systematic review and meta-analysis

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