Meta-Analysis of Bioprosthetic Valve Thrombosis After Transcatheter Aortic Valve Implantation
Section snippets
Methods
Medline, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), scientific session abstracts and other relevant websites (www.clinicaltrialresults.org, www.escardio.org, www.tctmd.com, www.theheart.org) were searched for studies dealing with the topic under investigation without restricting to language status. Each database was screened for studies published between January 2010 and December 2019. The references listed in all eligible studies were checked to identify further
Results
The flow diagram for the trial selection process is shown in the Supplemental Figure 1. After application of inclusion/exclusion criteria twenty studies (5 randomized controlled trials1,2,5,12,13 and 15 observational studies6, 7, 8,14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25) with a total of 12,128 patients who underwent TAVI were included. No disagreements required solution by the third reviewer. Nine studies selectively reported on CVT,1,2,7,8,21, 22, 23, 24, 25 5 studies investigated SLT,5
Discussion
This study summarizes the prevalence and clinical relevance of SLT or CVT after TAVI in a cohort of 12,128 patients. The results can be summarized as follows: (1) The pooled prevalence of SLT and CVT after TAVI was 15.1% and 1.2%, respectively; (2) the presence of either SLT or CVT does not significantly increase the risk of all-cause death after TAVI; (3) the risk of stroke is significantly and almost 8-fold higher in patients with CVT, whereas it was numerically higher without reaching
Contributions
SC, MJ and TR did the data analysis and wrote the first draft of the report. SC, MJ, TR, EX, NPM, MM and SS were involved in study conception and design. TR, CP, SS, MM and FA were involved in data acquisition. TR, TP, OH, SA, SW, SC and MJ revised the manuscript for important intellectual content. All authors approved the report for final submission.
Disclosures
M. Joner reports personal fees from Biotronik, personal fees from Orbus Neich, grants and personal fees from Boston Scientific, grants and personal fees from Edwards Lifesciences, personal fees from Astra Zeneca, personal fees from Recor and grants from Amgen. All other authors have no conflicts of interest to declare.
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