Comparison 30-day clinical complications between transfemoral versus transapical aortic valve replacement for aortic stenosis: a meta-analysis review

Journal of Cardiothoracic Surgery

Aiqiang Dong¹  Daming Jiang¹  Minjian Kong¹  Xuebiao Li¹ 

[1] Cardiaovascular surgery, Department of second affiliated hospital, school of Medicine, Zhejiang university, No. 88, Jie fang road, Hangzhou, Zhejiang province 310009, China

关键词: Meta-analysis;    Aortic stenosis;    Transapical;    Transfemoral;    Transcatheter aortic valve implantation;   

Others  :  824318
DOI  :  10.1186/1749-8090-8-168

 received in 2012-10-31, accepted in 2013-06-25,  发布年份 2013

【 摘 要 】

Background

Since 2002, transapical aortic valve replacement has been developed as a clinical pathway for transcatheter aortic valve implantation (TAVI). However the appropriate role of TA in the AS population versus TF remains unclear. We performed a meta-analysis to assess if TF has any benefit in reduction of 30-day clinical complications in AS.

Methods

We conducted a comprehensive search on pub-med and web of knowledge from 2002 through September 2012 using following terms: aortic stenosis, aortic valve replacement, transcatheter aortic valve implantation, TAVI, trans-artery, transfemoral, trans-apical. Studies in the original research or review articles were also considered. Included studies must meet the preconditioned criterias. Two investigators independently browsed the studies by title and abstract, finally making decision according to full-text. Disagreements were discussed in group.

Results

A total of 20 studies met inclusion criteria’s and were included in the analysis (including 4267 patients in TF group, 2242 in TA group). No random clinical trial, one was a retrospective study, others were prospective trials. Our meta-analysis found that TF had the low incidence of 30-day mortality compared with TA procedure (7.5% versus 11.3%). The incidence of stroke at ≤ 30 days was relatively low (3.8% in TF versus 4.0% in TA). Although the incidence of post-operative heart block was high (8.5% versus 7.5%), but no differences were indicated [1.06,95% CI(0.85,1.33)].

Conclusions

The result of our meta-analysis suggested that TF may have a low risk for 30-day mortality against TA procedure. No difference was found in the incidence of post-operative stroke and heart block.

【 授权许可】

   
2013 Li et al.; licensee BioMed Central Ltd.

【 图 表 】

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