Abstract 17388: Post-procedural Aortic Regurgitation in Patients Undergoing Transcatheter Aoritc Valve Implantation with Edwards SAPIEN Valve versus Medtronic CoreValve for Severe Aortic Stenosis: a Meta-analysis
Background: Transcatheter aortic valve implantation (TAVI) is performed using an Edwards SAPIEN valve (EV) or Medtronic CoreValve (CV) in patients with severe aortic stenosis who are not a candidate for surgical aortic valve replacement. The objective of this meta-analysis is to compare post-procedural aortic regurgitation (AR) in patients who underwent TAVI using EV and CV.
Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched through May 2014. Twelve studies (n=3245) comparing TAVI procedure that used EV (n=1490) and CV (n=1755) were included. End point was post-procedural aortic valve regurgitation. The odds ratio (OR) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance.
Results: The studies were homogeneous. AR grade 2 or more (moderate to severe) was significantly higher in CV group compared to EV group (OR: 2.25, CI: 1.72-2.95, p<0.00001) (Figure). AR grade 3 or more (severe) was not significantly different between two groups (OR: 2.20, CI: 1.01-4.79, p=0.05).
Conclusion: The results of our meta-analysis of 3245 patients suggest that TAVI procedure using CV may have two times higher incidence of moderate to severe post-procedural AR compared to TAVI procedure using EV. Our study also suggests that TAVI procedure using CV may have two times higher incidence of severe post-procedural AR compared to TAVI procedure using EV, but this outcome had a borderline statistical significance. This could be secondary to lower number of studies with insufficient sample size (7 studies, n=1444) available for severe AR outcome which may cause a beta-error. Randomized controlled trials with large patient population are needed to further evaluate post-procedural AR outcome at long term
Author Disclosures: H.B. Panchal: None. N. Barry: None. S. Bhatheja: None. K. Albalbissi: None. V. Ramu: None. T. Paul: None.
- © 2014 by American Heart Association, Inc.