Meta-Analysis of Perioperative Stroke and Mortality in Transcatheter Aortic Valve Implantation

Transcatheter aortic valve implantation (TAVI) is a rapidly evolving safe method with decreasing incidence of perioperative stroke. There is a void in literature concerning the impact of stroke after TAVI in predicting 30-day stroke-related mortality. The primary aim of this meta-analysis was to det...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of cardiology 2016-10, Vol.118 (7), p.1031-1045
Main Authors: Muralidharan, Aditya, Thiagarajan, Karthy, Van Ham, Raymond, Gleason, Thomas G., Mulukutla, Suresh, Schindler, John T., Jeevanantham, Vinodh, Thirumala, Parthasarathy D.
Format: Article
Language:English
Subjects:
Age
Aged
Aged, 80 and over
Aortic Valve Stenosis - surgery
Bias
Cause of Death
Female
Humans
Incidence
Intraoperative Complications - epidemiology
Intraoperative Complications - mortality
Male
Mortality
Odds Ratio
Perioperative Period
Postoperative Complications - epidemiology
Postoperative Complications - mortality
Quality
Regression Analysis
Statistical analysis
Stroke
Stroke - epidemiology
Stroke - mortality
Studies
Transcatheter Aortic Valve Replacement
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Transcatheter aortic valve implantation (TAVI) is a rapidly evolving safe method with decreasing incidence of perioperative stroke. There is a void in literature concerning the impact of stroke after TAVI in predicting 30-day stroke-related mortality. The primary aim of this meta-analysis was to determine whether perioperative stroke increases risk of stroke-related mortality after TAVI. Online databases, using relevant keywords, and additional related records were searched to retrieve articles involving TAVI and stroke after TAVI. Data were extracted from the finalized studies and analyzed to generate a summary odds ratio (OR) of stroke-related mortality after TAVI. The stroke rate and stroke-related mortality rate in the total patient population were 3.07% (893 of 29,043) and 12.27% (252 of 2,053), respectively. The all-cause mortality rate was 7.07% (2,053 of 29,043). Summary OR of stroke-related mortality after TAVI was estimated to be 6.45 (95% confidence interval 3.90 to 10.66, p 6 times greater risk of 30-day stroke-related mortality. Transapical TAVI is not associated with increased stroke-related mortality in patients who suffer from perioperative stroke. Preventative measures need to be taken to alleviate the elevated rates of stroke after TAVI and subsequent direct mortality.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.07.011