Author + information
- Krishna Kandregula,
- Kinjal Banerjee,
- Brandon Jones,
- Yash Jobanputra,
- Amar Krishnaswamy,
- Stephanie Mick,
- Jose Navia,
- Zoran Popovic,
- Lars Svensson,
- E. Murat Tuzcu and
- Samir Kapadia
Background: BPD is deemed essential before Transcatheter Aortic Valve Replacement (TAVR) with unclear impact on outcomes. Thus, we want to study the outcomes of TAVR without balloon predilation (BPD).
Methods: TAVR studies published between 2002 and October 2016 were reviewed. From 1217 initial citations, 22 studies reporting on 4530 patients were analyzed for outcomes post-TAVR using the random effects model.
Results: The 30 day mortality is 4.88% vs 5.91%, 1 year mortality is 14.33% vs 14.11%, device success is 89.88% vs 88.32% in no BPD group vs BPD group respectively. The mean procedure time and mean contrast volume were significantly lower by 39 min and 24 ml respectively in no BPD group as compared to BPD group. Meta-analysis showed no significant difference for all-cause mortality at 30-days [Odds Ratio (OR)-0.83; 95% Confidence interval (CI):0.60-1.14] or 1-year (OR-0.81; 95%CI:0.51-1.28) with significantly higher device success (OR-1.65; 95%CI:1.20-2.26) in no BPD group as compared to BPD group. The incidence of moderate/severe residual Paravalvular leakage (PVL) (OR-0.48; 95%CI:0.27-0.87), major vascular complications (OR-0.68; 95%CI:0.51-0.91), need for conversion to surgery (OR-0.42; 95%CI:0.19-0.93) were significantly lower in the no BPD group as compared to BPD group.
Conclusions: TAVR without BPD showed better outcomes in terms of device success, PVL, major vascular complications, need for conversion to surgery with lower total procedure time and contrast volume.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-194
- 2017 American College of Cardiology Foundation