Valve Type and Operative Risks in Surgical Explantation of Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis.
Riccardo G AbbascianoDimitrios E MagouliotisMarinos KoulouroudiasKyriakos SpiliopoulosAndrew V XanthopoulosAntonios KourliourosRoberto CasulaThanos AthanasiouAlessandro VivianoPublished in: Journal of clinical medicine (2024)
Indication to perform surgical explantation of TAVR is becoming increasingly more frequent, due to the higher number of transcatheter procedures performed in patients with longer life expectancy. We proposed to perform a systematic review and meta-analysis with metaregression to identify potential factors that can determine an increase in the high mortality and morbidity that characterize these surgical procedures. MEDLINE and Embase were searched for relevant studies. Twelve studies were eligible according to our inclusion criteria. TAVR explantation was confirmed as a procedure with high 30-day mortality (0.17; 95% CI, 0.14-0.21) and morbidity (stroke incidence 5%; 95% CI, 0.04-0.07; kidney injury incidence 16%; 95% CI, 0.11-0.24). The type of transcatheter valve implanted during the index procedure did not influence the outcomes after surgical explantation. The role of these high-risk operations is growing, and it will likely expand in the coming years. Specific tools for risk stratification are required.
Keyphrases
- aortic valve
- aortic stenosis
- transcatheter aortic valve replacement
- risk factors
- transcatheter aortic valve implantation
- aortic valve replacement
- mitral valve
- cardiovascular events
- atrial fibrillation
- minimally invasive
- left ventricular
- heart failure
- human health
- coronary artery disease
- ejection fraction
- climate change
- subarachnoid hemorrhage
- pulmonary arterial hypertension