Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jun 21;24(1):314.
doi: 10.1186/s12872-024-03980-2.

The evolution of TAVI performance overtime: an overview of systematic reviews

Carmen Angioletti  1 , Giaele Moretti  2 , Stefania Manetti  3 , Luigi Pastormerlo  4 , Milena Vainieri  1 , Claudio Passino  4   5
Affiliations
Review

The evolution of TAVI performance overtime: an overview of systematic reviews

Carmen Angioletti et al. BMC Cardiovasc Disord. .

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is a well-established treatment for high and intermediate-risk patients with severe aortic stenosis (AS). Recent studies have demonstrated non-inferiority of TAVI compared to surgery in low-risk patients. In the past decade, numerous literature reviews (SLRs) have assessed the use of TAVI in different risk groups. This is the first attempt to provide an overview of SRs (OoSRs) focusing on secondary studies reporting clinical outcomes/process indicators. This research aims to summarize the findings of extant literature on the performance of TAVI over time.

Methods: A literature search took place from inception to April 2024. We searched MEDLINE and the Cochrane Library for SLRs. SLRs reporting at least one review of clinical indicators were included. Subsequently, a two-step inclusion process was conducted: [1] screening based on title and abstracts and [2] screening based on full-text papers. Relevant data were extracted and the quality of the reviews was assessed.

Results: We included 33 SLRs with different risks assessed via the Society of Thoracic Surgeons (STS) score. Mortality rates were comparable between TAVI and Surgical Aortic Valve Replacement (SAVR) groups. TAVI is associated with lower rates of major bleeding, acute kidney injury (AKI) incidence, and new-onset atrial fibrillation. Vascular complications, pacemaker implantation, and residual aortic regurgitation were more frequent in TAVI patients.

Conclusion: This study summarizes TAVI performance findings over a decade, revealing a shift to include both high and low-risk patients since 2020. Overall, TAVI continues to evolve, emphasizing improved outcomes, broader indications, and addressing challenges.

Keywords: Review; Surgical aortic valve replacement; Transcatheter aortic valve replacement.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Workflow for the selection of eligible studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria
Fig. 2
Fig. 2
Distribution of risk classes included in studies per different years. The figure reports the number of studies including All risks of patients, high, intermediate, low to intermediate, and low risk distribution per year. *The year 2023 includes also one paper published in 2024
See this image and copyright information in PMC

References

    1. Epidemiology of aortic valve stenosis (AS) and of aortic valve incompetence (AI). is the prevalence of AS/AI similar in different parts of the world? [Internet]. [cited 2023 Jul 7]. https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volum....
    1. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J [Internet]. 1987 [cited 2024 May 3];8(5):471–83. https://pubmed.ncbi.nlm.nih.gov/3609042/. - PubMed
    1. Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. NEJM org N Engl J Med. 2014;19(8):1790–8. doi: 10.1056/NEJMoa1400590. - DOI - PubMed
    1. Mack MJ, Leon MB, Thourani VH, Pibarot P, Hahn RT, Genereux P et al. Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years. New England Journal of Medicine [Internet]. 2023 Nov 23 [cited 2024 May 3];389(21):1949–60. https://www.nejm.org/doi/full/10.1056/NEJMoa2307447. - PubMed
    1. AMSTAR -. Assessing the Methodological Quality of Systematic Reviews [Internet]. [cited 2023 Mar 6]. https://amstar.ca/Amstar_Checklist.php.

Publication types

MeSH terms