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      Balloon-expandable versus self-expanding transcatheter aortic valve replacement for bioprosthetic dysfunction: A systematic review and meta-analysis

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          Abstract

          Background

          Transcatheter aortic valve-in-valve (VIV) procedure is a safe alternative to conventional reoperation for bioprosthetic dysfunction. Balloon-expandable valve (BEV) and self-expanding valve (SEV) are the 2 major types of devices used. Evidence regarding the comparison of the 2 valves remains scarce.

          Methods

          A systematic review and meta-analysis was conducted to compare the outcomes of BEV and SEV in transcatheter VIV for aortic bioprostheses dysfunction. A computerized search of Medline, PubMed, Embase, and Cochrane databases was performed. English-language journal articles reporting SEV or BEV outcomes of at least 10 patients were included.

          Results

          In total, 27 studies were included, with 2,269 and 1,671 patients in the BEV and SEV groups, respectively. Rates of 30-day mortality and stroke did not differ significantly between the 2 groups. However, BEV was associated with significantly lower rates of postprocedural permanent pacemaker implantation (3.8% vs. 12%; P < 0.001). Regarding echocardiographic parameters, SEV was associated with larger postprocedural effective orifice area at 30 days (1.53 cm 2 vs. 1.23 cm 2; P < 0.001) and 1 year (1.55 cm 2 vs. 1.22 cm 2; P < 0.001).

          Conclusions

          For patients who underwent transcatheter aortic VIV, SEV was associated with larger postprocedural effective orifice area but higher rates of permanent pacemaker implantation. These findings provide valuable information for optimizing device selection for transcatheter aortic VIV.

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          Most cited references40

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          Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: a meta-analysis.

          Atrioventricular (AV) conduction disturbances requiring permanent pacemaker (PPM) implantation may complicate transcatheter aortic valve replacement (TAVR). Available evidence on predictors of PPM is sparse and derived from small studies.
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            Transcatheter Aortic Valve Implantation Within Degenerated Aortic Surgical Bioprostheses: PARTNER 2 Valve-in-Valve Registry.

            Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results.
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              • Article: not found

              Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry.

              There are limited data on coronary obstruction following transcatheter valve-in-valve (ViV) implantation inside failed aortic bioprostheses. The objectives of this study were to determine the incidence, predictors, and clinical outcomes of coronary obstruction in transcatheter ViV procedures.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: MethodologyRole: SupervisionRole: Validation
                Role: Writing – review & editing
                Role: Data curationRole: MethodologyRole: Software
                Role: Data curationRole: Formal analysisRole: Software
                Role: ConceptualizationRole: InvestigationRole: Methodology
                Role: ConceptualizationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Formal analysisRole: Software
                Role: MethodologyRole: ResourcesRole: Validation
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: MethodologyRole: Resources
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                1 June 2020
                2020
                : 15
                : 6
                : e0233894
                Affiliations
                [1 ] Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan
                [2 ] Division of Cardiovascular Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
                [3 ] Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan
                [4 ] Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan City, Taiwan
                [5 ] Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan
                Erasmus Medical Center, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-2573-0598
                Article
                PONE-D-20-05542
                10.1371/journal.pone.0233894
                7263630
                32479546
                691832f3-d371-4d81-821e-1af7afe6d432
                © 2020 Lee et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 26 February 2020
                : 14 May 2020
                Page count
                Figures: 4, Tables: 2, Pages: 14
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100012553, Chang Gung Memorial Hospital;
                Award ID: CMRPG3H1511
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100012553, Chang Gung Memorial Hospital;
                Award ID: CMRPG 3J0661
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100012553, Chang Gung Memorial Hospital;
                Award ID: BMRPD95
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100004663, Ministry of Science and Technology, Taiwan;
                Award ID: MOST 107-2314-B-182A-152
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100004663, Ministry of Science and Technology, Taiwan;
                Award ID: MOST 108-2314-B-182A-141
                Award Recipient :
                This work was supported by a grant from Chang Gung Memorial Hospital, Taiwan CMRPG3H1511 (SWC), CMRPG 3J0661 (SWC), and BMRPD95 (SWC). This work was also supported by Ministry of Science and Technology grants MOST 107-2314-B-182A-152 and MOST 108-2314-B-182A-141 (SWC). The authors are thankful for the statistical assistance provided by and acknowledge the support of the Maintenance Project of the Center for Big Data Analytics and Statistics (grant CLRPG3D0045) at Chang Gung Memorial Hospital for statistical consultation and data analysis. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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