Clinical outcomes and the impact of valve morphology for transcatheter aortic valve replacement in bicuspid aortic valves: A systematic review and meta‐analysis

• Published in: Catheterization and cardiovascular interventions 2023-10, Vol.102 (4), p.721-730
• Main Authors: Gupta, Rahul, Mahmoudi, Elham, Behnoush, Amir Hossein, Malik, Aaqib H., Mahajan, Pranav, Lin, Muling, Bandyopadhyay, Dhrubajyoti, Goel, Akshay, Chakraborty, Sandipan, Aedma, Surya K., Gupta, Harsh Bala, Vyas, Apurva V., Combs, William G., Mathur, Moses, Yakubov, Steven J., Patel, Nainesh C.
• Format: Article
• Language: English
• Subjects: Aortic stenosis; Aortic valve; Calcification; Clinical trials; Meta-analysis; Mortality; Patients; Regurgitation
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.30808

BackgroundBicuspid aortic valve (BAV) is present in approximately 0.5%–2% of the general population, causing significant aortic stenosis (AS) in 12%–37% of affected individuals. Transcatheter aortic valve replacement (TAVR) is being considered the treatment of choice in patients with symptomatic AS across all risk spectra.AimAim Our study aims to compare TAVR outcomes in patients with BAV versus tricuspid aortic valves (TAV).MethodsA comprehensive literature search was performed in PubMed, Web of Science, and Cochrane trials. Studies were included if they included BAV and TAV patients undergoing TAVR with quantitative data available for at least one of our predefined outcomes. Meta‐analysis was performed by the random‐effects model using Stata software.ResultsFifty studies of 203,288 patients were included. BAV patients had increased 30‐day all‐cause mortality (odds ratio [OR] = 1.23 [1.00–1.50], p = 0.05), in‐hospital stroke (OR = 1.39 [1.01–1.93], p = 0.05), in‐hospital and 30‐day PPI (OR = 1.13 [1.00–1.27], p = 0.04; OR = 1.16 [1.04–1.13], p = 0.01) and in‐hospital, 30‐day and 1‐year aortic regurgitation (AR) (OR = 1.48 [1.19–1.83], p