Single-arm Meta-analysis of Argentine Studies Reporting 30-Day Mortality After Transcatheter Aortic Valve Implantation in Intermediate-Risk Patients

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Abstract

Background: Transcatheter aortic valve implantation (TAVI) has proved to be beneficial in intermediate-risk patients; however, there is no analysis reporting overall TAVI results in our country.

Objectives: The aim of this investigation was to conduct a meta-analysis of single-arm local studies reporting in-hospital TAVI outcomes in intermediate-risk patients in Argentina.

Methods: A systematic review was performed including observational TAVI studies identified in MEDLINE, Embase, SCOPUS and Cochrane to August 2019.

Results: Among 59 articles identified through the database search, only 4 local observational studies reported 30-day mortality and complications after TAVI in moderate-risk patients, with Society of Thoracic Surgeons (STS) score ranging between 4% and 7%. In 494 patients, 30-day mortality was 4.8%. Weighted pooled estimates of the studies were: stroke 2.7%, myocardial infarction 1.0%, need for definitive pacemaker 24.8%, moderate or severe periprosthetic leak 16.7%, and major bleeding 5.5%.

Conclusions: The proven efficacy of TAVI is expanding its indication to intermediate and low-risk patients. However, this shift should be supported by local evidence of its benefit over traditional valve surgery. This single-arm meta-analysis of Argentine studies presents 30-day mortality and complications after TAVI in intermediate-risk patients. The updated information of local TAVI outcomes will serve as a standard in our setting.