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
Meta-Analysis
. 2025 Jan 19;12(1):e003110.
doi: 10.1136/openhrt-2024-003110.

Emergency interventions for cardiogenic shock due to decompensated aortic stenosis: a systematic review and meta-analysis

Stephanie Gladys Kühne  1 , Andrea Patrignani  2 , Sebastien Elvinger  1 , Bastian Wein  1 , Eva Harmel  1 , Damyan Penev  1 , Tamer Owais  3 , Evaldas Girdauskas  3 , Philip W Raake  4 , Mauro Chiarito  2 , Dario Bongiovanni  4
Affiliations
Meta-Analysis

Emergency interventions for cardiogenic shock due to decompensated aortic stenosis: a systematic review and meta-analysis

Stephanie Gladys Kühne et al. Open Heart. .

Abstract

Background: Cardiogenic shock (CS) induced by severe aortic stenosis (AS) is a life-threatening condition with high mortality. Despite advancements in emergency interventions, the optimal treatment approach remains uncertain.

Aim: This study aimed to systematically review and analyse the existing evidence on outcomes of emergency transcatheter aortic valve implantation (eTAVI) and emergency balloon aortic valvuloplasty (eBAV) in CS patients.

Methods: A systematic literature review and meta-analysis was performed. The primary endpoint was mortality at 30 days. Secondary endpoints were in-hospital mortality, 1-year mortality, bleeding, major vascular complications, myocardial infarction, stroke, incidence of pacemaker implantation, acute kidney injury and aortic regurgitation.

Results: Seventeen studies were included, totalling 2811 patients. The analysis revealed a 30-day mortality pooled estimated rate for eTAVI of 19% (CI 0.17 - 0.20) and for eBAV 39% (CI 0.32 - 0.46). In-hospital mortality pooled estimated rates were 11% for eTAVI (CI 0.06 - 0.18) and for eBAV 40% (CI 0.28 - 0.54). One-year mortality pooled estimated rates for eTAVI were 29% (CI 0.20 - 0.40) and for eBAV 67% (CI 0.58 - 0.74). Pooled estimated rates of any bleeding were 12% for eTAVI (CI 0.06 - 0.20) and 15% for eBAV (CI 0.10 - 0.21). The rate of major vascular complications for eTAVI was 8% (CI 0.07 - 0.10) and 3% for eBAV (CI 0.0 - 0.23).

Conclusions: This meta-analysis indicates that mortality in CS due to AS remains high despite emergency interventional treatment. These findings offer critical insights for clinical decision-making optimising patient care in this critically ill population.

Keywords: Aortic Valve Stenosis; Heart Valve Prosthesis Implantation; Meta-Analysis; Systematic Reviews as Topic; Transcatheter Aortic Valve Replacement.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. 30-day mortality. Pooled estimated rates for 30-day mortality after eBAV (A) and after eTAVI (B) in CS patients. CS, cardiogenic shock; eBAV, emergency balloon aortic valvuloplasty; eTAVI, emergency transcatheter aortic valve implantation.
Figure 2
Figure 2. One-year mortality. Pooled estimated rates for 1-year mortality after eBAV (A) and after eTAV (B) in CS patients. CS, cardiogenic shock; eBAV, emergency balloon aortic valvuloplasty; eTAVI, emergency transcatheter aortic valve implantation.
Figure 3
Figure 3. Bleeding complications. Pooled estimated rates for bleeding after eBAV (A) and after eTAVI (B) in CS patients. CS, cardiogenic shock; eBAV, emergency balloon aortic valvuloplasty; eTAVI, emergency transcatheter aortic valve implantation.
Figure 4
Figure 4. Vascular complications. Pooled estimated rates for major vascular complications after eBAV (A) and after eTAVI (B) in CS patients. CS, cardiogenic shock; eBAV, emergency balloon aortic valvuloplasty; eTAVI, emergency transcatheter aortic valve implantation.
See this image and copyright information in PMC

References

    1. Osnabrugge RLJ, Mylotte D, Head SJ, et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013;62:1002–12. doi: 10.1016/j.jacc.2013.05.015. - DOI - PubMed
    1. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005–11. doi: 10.1016/S0140-6736(06)69208-8. - DOI - PubMed
    1. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106:3006–8. doi: 10.1161/01.cir.0000047200.36165.b8. - DOI - PubMed
    1. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–607. doi: 10.1056/NEJMoa1008232. - DOI - PubMed
    1. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364:2187–98. doi: 10.1056/NEJMoa1103510. - DOI - PubMed

MeSH terms

LinkOut - more resources