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Impact of stent deformity induced by the kissing balloon technique for bifurcating lesions on in-stent restenosis after coronary intervention Multicenter Registry of Real-World Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy: 1-Year Outcomes Treating Bifurcation Lesions: The Result Overcomes the Technique The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry Bare metal or drug-eluting stent versus drug-coated balloon in non-ST-elevation myocardial infarction: the randomised PEPCAD NSTEMI trial Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting Percutaneous coronary interventional strategies for treatment of in-stent restenosis: a network meta-analysis Chronic Total Occlusion Interventions: Update on Current Tips and Tricks Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study The European bifurcation club Left Main Coronary Stent study: a randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN)
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Review Article2019 May 25. pii: S0002-9149(19)30584-3.

JOURNAL：Am J Cardiol. Article Link

Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort

Ando T, Ashraf S, Villablanca P et al. Keywords: transcatheter aortic valve implantation; surgical aortic valve replacement; low-to-intermediate surgical risk cohort

ABSTRACT

Transcatheter aortic valve implantation (TAVI) has been used to treat high surgical risk cohorts but has been expanded to treat low-to-intermediate risk cohort as well. We performed a systematic review and meta-analysis to compare the outcomes between TAVI and surgical aortic valve replacement (SAVR) in low-to-intermediate risk cohort. We queried PUBMED, EMBASE, and ClinicalTrial.gov for relevant articles. Randomized controlled trials that compared at least one of the outcomes of interest between TAVI and SAVR were included. Risk ratio (RR) and 95% confidence interval (CI) were pooled with a random-effects model to compare the risk of the primary outcome between the 2 procedures. The primary outcome was a composite of all-cause mortality or disabling/major stroke at 1 year. Seven studies with a total of 7,143 patients (3,665 TAVI) were included. All-cause mortality or disabling/major stroke at 30 days (6 studies, RR 0.71, 95% CI 0.49 to 1.03) was similar between TAVI and SAVR but was significantly lower in TAVI at 1 year (5 studies, RR 0.81, 95% CI 0.67 to 0.98). All-cause mortality was similar at both 30 days (7 studies, RR 0.90, 95% CI 0.67 to 1.21) and 1 year (6 studies, RR 0.89, 95% CI 0.76 to 1.04). Disabling/major stroke was similar between the 2 procedures (6 studies, RR 0.69, 95% CI 0.42 to 1.12) at 30 days but was significantly lower in TAVI at 1 year (5 studies RR 0.71, 95% CI 0.51 to 0.98). Age, gender, diabetes, and surgical risk score did not modulate the primary outcome. TAVI had a significantly lower composite of all-cause mortality or disabling/major stroke at 1 year compared with SAVR in low-to-intermediate surgical risk cohort.

Copyright © 2019 Elsevier Inc. All rights reserved.

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