Transcatheter Aortic Valve Implantation in Cardiac Amyloidosis and Aortic Stenosis
Section snippets
Methods
This systematic review and meta-analysis was conducted and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.9 Medline, Scopus, and Cochrane Central Register of Controlled Trials were searched from database inception through February 2022, using the following combination of keywords: (aortic stenosis OR aortic valvulopathy OR AS) AND (cardiac amyloidosis OR transthyretin amyloidosis OR amyloidosis) AND (transcatheter aortic valve replacement
Results
The literature search yielded 377 articles; 4 observational studies involving 83 patients were included (Figure 1). The characteristics of the included studies are summarized in Table 1. The general demographics and baseline characteristics of patients is listed in Table 2.
Of the 83 patients, 45 underwent TAVI (54%), and 38 received conservative medical management without undergoing TAVI (46%). AS was classified as severe in 80 of 83 patients (96%). In the 3 studies that presented patient
Discussion
This meta-analysis demonstrates improved survival in patients with concomitant moderate-to-severe AS and CA who underwent TAVI compared with medical therapy alone (Figure 3). This study suggests that TAVI in patients with CA/AS is associated with lower mortality than medical therapy alone.
CA is a complicating co-morbidity for a significant proportion of patients with AS who underwent TAVI. Recent studies have suggested that the prevalence of CA in patients with AS is much higher than previously
Ethics approval and consent to participate
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this was a meta-analysis, this study did not require approval by our institutional review board. This article does not contain any studies with animals performed by any of the authors.
Disclosures
The authors have no conflicts of interest to declare.
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Cited by (1)
Cardiac Amyloidosis in Patients With Severe Aortic Stenosis: Not a Good Reason to Say No to Transcatheter Aortic Valve Implantation
2023, American Journal of Cardiology
Drs. Riley and Junarta contributed equally as co-first authors.
Funding: none.