Efficacy and safety of Transcatheter Aortic Valve Replacement in
patients with stenotic bicuspid aortic valve: a meta-analysis
Abstract
Objective: To assess clinical outcomes of Transcatheter Aortic
Valve Replacement in stenotic bicuspid aortic valve patients.
Methods: The search of clinical articles was conducted by using
Pubmed, Embase, The Cochrane Library databases. We compared clinical
outcomes of efficacy and safety endpoints between stenotic bicuspid
aortic valve(BAV) and tricuspid aortic valve(TAV) patients according to
Valve Academic Research Consortium-2 criteria. Results: 20
studies were included in the current meta analysis. BAV groups showed
higher post-procedural paravalvular leakage and stroke rate compared
with TAV groups. No discrepancy were detected in the mean aortic
gradient and aortic valve area between two groups. The 30-day and 1-year
mortality were similar in both groups. BAV group was more likely to be
associated with lower device success and higher incidence of conversion
to surgical aortic valve replacement, second valve implantation and
annular rupture. No difference was found in the incidence of permanent
pacemaker implantation, acute kidney disease, life-threatening bleeding
and myocardial infarction between bicuspid and tricuspid patients.
Conclusion: The efficacy and safety of TAVR in BAV patients
were not as ideal as those in TAV patients. Cautious and adequate
discussion must be made before we decide to perform TAVR procedure for
BAV patients.