Pooled-Analysis of Association of Sievers Bicuspid Aortic Valve Morphology With New Permanent Pacemaker and Conduction Abnormalities After Transcatheter Aortic Valve Replacement

Frontiers in Cardiovascular Medicine

article

Jiajun Zhang¹  Xiaoxing Li⁴  Feng Xu¹  Yuguo Chen¹  Chuanbao Li¹ 

[1] Department of Emergency Medicine and Chest Pain Center, Cheeloo College of Medicine, Qilu Hospital of Shandong University;Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University;Key Laboratory of Cardiovascular Remodeling and Function Research, Qilu Hospital of Shandong University;Department of Geriatrics, Qilu Hospital of Shandong University

关键词: bicuspid aortic valve;    transcatheter aortic valve replacement;    conduction abnormalities;    aortic stenosis (AS);    Sievers classification;    pacemaker;   

DOI  :  10.3389/fcvm.2022.884911

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Studies on the association of Sievers bicuspid aortic valve (BAV) morphology with conduction disorders after transcatheter aortic valve replacement (TAVR) have not reached consensus. Methods We here performed a pooled-analysis to explore whether Sievers type 1 BAV morphology increased the risk of post-TAVR conduction abnormalities and permanent pacemaker implantation (PPI) compared to type 0. Systematic literature searches through EMBASE, Medline, and Cochrane databases were concluded on 1 December 2021. The primary endpoint was post-TAVR new PPI and pooled as risk ratios (RRs) and 95% confidence intervals (CIs). Conduction abnormalities as the secondary endpoint were the composites of post-TAVR PPI and/or new-onset high-degree of atrial-ventricle node block and left-bundle branch block. Studies that reported incidence of outcomes of interest in both type 1 and type 0 BAV morphology who underwent TAVR for aortic stenosis were included. Results Finally, nine studies were included. Baseline characteristics were generally comparable, but type 1 population was older with a higher surgical risk score compared to type 0 BAV morphology. In the pooled-analysis type 1 BAV had significantly higher risk of post-TAVR new-onset conduction abnormalities ( RR = 1.68, 95% CI 1.09–2.60, p = 0.0195) and new PPI ( RR = 1.97, 95% CI 1.29–2.99, p = 0.0016) compared to type 0. Random-effects univariate meta-regression indicated that no significant association between baseline characteristics and PPI. Conclusion Sievers type 1 BAV morphology was associated with increased risk of post-TAVR PPI and conduction abnormalities compared to type 0. Dedicated cohort is warranted to further validate our hypothesis.

【 授权许可】

CC BY