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Post‐dilation in transcatheter aortic valve replacement: A systematic review and meta‐analysis

Post‐dilation in transcatheter aortic valve replacement: A systematic review and meta‐analysis INTRODUCTIONTranscatheter aortic valve replacement (TAVR) has emerged as a viable option for patients with severe aortic stenosis who are not candidates for cardiac surgery or at high risk of surgical complications. With the results of the PARTNER II trials, TAVR also appears to be a viable option in intermediate risk patients. Although TAVR has been associated with excellent valve haemodynamics, paravalvular aortic regurgitation (PVR) represents a major concern and has been reported in 80‐96% of procedures. In particular, moderate to severe PVR occurs in 9.6‐14.1% of cases, and is a predictor of adverse outcomes. Subsequently methods have been developed to minimize the frequency of moderate to severe PVR to rates as low as 3.7% at 30 days.One technique to treat patients with PVR during the procedure is post dilation (PD) of the prosthesis after valve implantation. There have been several reports on the success of PD in reducing PVR in the majority of patients studied. However, PD has been associated with higher incidences of stroke and some patients do not appear to derive benefit.Therefore, the aim of this study was to perform a meta‐analysis to compare the outcomes of patients undergoing TAVR with and without PD. In those patients http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Post‐dilation in transcatheter aortic valve replacement: A systematic review and meta‐analysis

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References (30)

Publisher
Wiley
Copyright
© 2017 Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/joic.12378
pmid
28321917
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONTranscatheter aortic valve replacement (TAVR) has emerged as a viable option for patients with severe aortic stenosis who are not candidates for cardiac surgery or at high risk of surgical complications. With the results of the PARTNER II trials, TAVR also appears to be a viable option in intermediate risk patients. Although TAVR has been associated with excellent valve haemodynamics, paravalvular aortic regurgitation (PVR) represents a major concern and has been reported in 80‐96% of procedures. In particular, moderate to severe PVR occurs in 9.6‐14.1% of cases, and is a predictor of adverse outcomes. Subsequently methods have been developed to minimize the frequency of moderate to severe PVR to rates as low as 3.7% at 30 days.One technique to treat patients with PVR during the procedure is post dilation (PD) of the prosthesis after valve implantation. There have been several reports on the success of PD in reducing PVR in the majority of patients studied. However, PD has been associated with higher incidences of stroke and some patients do not appear to derive benefit.Therefore, the aim of this study was to perform a meta‐analysis to compare the outcomes of patients undergoing TAVR with and without PD. In those patients

Journal

Journal of Interventional Cardiology – Wiley

Published: Jun 1, 2017

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