Meta-analysis Comparing Transcatheter and Surgical Treatments of Paravalvular Leaks

The American Journal of Cardiology
Tatiana BusuMohamad Alkhouli

Abstract

Percutaneous paravalvular leak (PVL) closure has emerged as a feasible alternative to redo valve surgery. However, comparative data on percutaneous and surgical treatment of PVL are scarce. We performed a systematic review and a meta-analysis of studies on percutaneous and surgical treatments of PVL. Of the 2,267 studies screened, 22 eligible studies were analyzed. Primary end points were technical success, 30-day mortality, stroke, and length of stay. Secondary end points were 1-year mortality, readmission for heart failure, reoperation, and symptomatic improvement at follow-up. A total of 2,373 patients were included, of whom 1,511 (63.7%) underwent percutaneous closure. Technical success was higher with surgery (96.7% vs 72.1%, odds ratio [OR] 9.7, p <0.001) but at the cost of higher 30-day mortality (8.6% vs 6.8%, OR 1.90, p <0.001), a trend toward higher stroke (3.3% vs 1.4%, OR 1.94, p = 0.069), and longer hospitalizations. However, surgery was associated with similar 1-year mortality (17.3% vs 17.2%, OR 1.07, p = 0.67), reoperation (9.1% vs 9.9%, OR 0.72, p = 0.1), readmission for heart failure (13.3% vs 26.4%, OR 0.51, p = 0.29), and improvement in New York Heart Association classification (67.4% vs 56%, OR 1.37, p = 0....Continue Reading

Citations

May 1, 2019·Clinical Cardiology·Mohamad AlkhouliChalak Berzingi
Jul 1, 2020·Texas Heart Institute Journal·Frank E Corrigan IiiStephen D Clements
Nov 16, 2019·Current Treatment Options in Cardiovascular Medicine·Samuel Bernard, Evin Yucel
Nov 28, 2019·Journal of Interventional Cardiology·Kuldeep ShahMohamad Alkhouli
Feb 23, 2021·Hellenic Journal of Cardiology : HJC = Hellēnikē Kardiologikē Epitheōrēsē·Konstantinos KalogerasManolis Vavuranakis
Mar 23, 2021·Journal of Interventional Cardiology·Yang LiuJian Yang
Apr 2, 2021·Asian Cardiovascular & Thoracic Annals·Palaparti RaghuramEjaz Ahamed Sheriff
Aug 29, 2020·Journal of Cardiovascular Medicine·Magdalena CumanAlberto Clemente
Nov 26, 2021·Journal of Cardiac Surgery·Imran Karim JanmohamedAmer Harky

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