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Transcatheter Aortic Valve Replacement for Pure Native Aortic Valve Regurgitation: A Systematic Review.

Jiang, Jubo; Liu, Xianbao; He, Yuxin; Xu, Qiyuan; Zhu, Qifeng; Jaiswal, Sanjay; Wang, Lihan; Hu, Po; Gao, Feng; Sun, Yinghao; Liu, Chunhui; Lin, Xiaoping; Liang, Jie; Ren, Kaida; Wang, Jian Apos An.
Cardiology; 141(3): 132-140, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517917

BACKGROUND:

Transcatheter aortic valve replacement (TAVR) is a recent and an effective treatment option for high- or extreme-surgical-risk patients with symptomatic severe aortic stenosis. However, pure severe native aortic valve regurgitation (NAVR) without aortic stenosis remains a contraindication to TAVR. The aim of our systemic review analysis was to evaluate TAVR in patients with pure NAVR.

METHODS:

We searched the published articles in the PubMed and Web of Science databases (2002-2017) using the Boolean operators for studies of NAVR patients undergoing TAVR. Reference lists of all returned articles were searched recursively for other relevant citations. Pooled estimates were calculated using a random-effects meta-analysis.

RESULTS:

Finally, a total of 10 studies were included in this analysis. The CoreValve was more frequently used with a lower rate of device success and a higher rate of residual aortic regurgitation. The new-generation transcatheter heart valves (THVs) performed a significantly higher rate with less residual aortic regurgitation and a success rate close to 100%. The 30-day all-cause mortality rates ranged from 0 to 30% with an estimate summary rate of 9% (95% CI 5-15%; I2 = 33%). Cerebrovascular events, major or life-threatening bleeding, major vascular complications, acute kidney disease, and new permanent pacemaker implantation occurred similarly in both the new- and old-generation THV devices.

CONCLUSIONS:

Aortic regurgitation remains a challenging pathology for TAVR. TAVR is a feasible and reasonable option for carefully selected patients with pure aortic regurgitation.
Selo DaSilva