Review Article - (2023) Volume 11, Issue 4
Received: 26-Dec-2022, Manuscript No. JCDD-22-84741 ;
Editor assigned: 29-Dec-2022, Pre QC No. JCDD-22-84741 (PQ);
Reviewed: 13-Jan-2023, QC No. JCDD-22-84741 ;
Revised: 16-Mar-2023, Manuscript No. JCDD-22-84741 (R);
Published:
24-Mar-2023
, DOI: 10.37421/2329-9517.2023.10.556
Citation: Sethi, Ankur, Emily Hiltner, Monarch
Shah and Derek Schwabe-Warf, et al.. "Comparison of Various
Transcatheter Aortic Valves for Aortic Stenosis a Network
Meta-analysis of Randomized Controlled Trials." J Cardiovasc Dis Diagn 11 (2023): 556
Copyright: © 2023 Sethi A, 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.
Objectives: Our aim was to compare available Transcatheter Aortic Valve Replacement (TAVR) valves using direct and indirect evidence from Randomized Controlled Trials (RCT).
Background: TAVR is now an established treatment for majority of patients with severe aortic stenosis. However, there is limited data comparing various valves.
Methods: We performed a systematic search of electronic databases for RCT comparing a TAVR valve to a valve or surgery. A Bayesian network meta-analysis was performed to compile evidence from both direct and indirect comparisons at 30 days and at one year.
Results: Twelve studies with 10,307 patients eligible for TAVR met the criteria and were included. Self-expanding Valve Core valve type (SEV_C) is associated with higher risk of pacemaker implantation and use of >1 valve, SEV Accurate type (SEV_A) is associated with higher risk of ≥ moderate Aortic Regurgitation (AR) and death, and Mechanically Expandable Valve (MEV) is associated with lower risk of ≥ moderate AR but higher risk of pacemaker at 30 days, SEV_C and MEV were associated with higher pacemaker rates compared balloon expandable valve (BEV) at 1 year. There is no difference among the valves in stroke at 30 days and 1 year.
Conclusions: At 30 days, BEV was superior on one or more outcomes of mortality, pacemaker implantation, >1 valve implantation and ≥ moderate AR compared to other valves except the higher rate ≥ moderate AR compared to MEV. At one year, BEV was associated with lower odds of pacemaker implantation compared to SEV_C and MEV but not different on other end points.
