Evidence-Based case report on the effect of TAVR on the severe aortic stenosis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Ruishuang ¹ , XU Yuanning ² ,  CHEN Mao ²

1. Department of General Practice, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

CHEN Mao, Email: hchenmao@vip.sina.com

Keywords：

Severe aortic stenosis; Transcatheter aortic valve replacement; Surgical aortic valve replacement

DOI：

10.7507/1672-2531.201609008

Video：

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Objective To search and review the best clinical evidence to compare the clinical therapeutic effects and safety between TAVR and SAVR, thereby guiding its clinical use and providing references of treatments for such patients. Methods EMbase (1974～2016), MEDLINE (1996～2016) and The Cochrane Library (Issue 5, 2016) were systematically retrieved to collect randomized control trials, case-control studies and meta-analyses. Then, we assessed the quality of all the evidences to develop treatments based on those evidences and the situations of such patients. Results We identified 21 articles, including 2 articles of meta-analysis. With regard to the mortality and incidence of cardiovascular events, TAVR was not worse than SAVR. In addition, TAVR was more dominant than SAVR for patients who combined more basic diseases. Conclusion TAVR is one of the effective treatments for most patients with severe AS after sufficient assessment.

Citation： LIURuishuang, XUNYuanning, CHENMao. Evidence-Based case report on the effect of TAVR on the severe aortic stenosis. Chinese Journal of Evidence-Based Medicine, 2017, 17(2): 243-248. doi: 10.7507/1672-2531.201609008 Copy

1.	Nishimura RA, Otto CM, Bonow RO,et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1): e1-e132.
2.	Kelly TA, Rothbart RM, Cooper CM,et al. Comparison of outcome of asymptomatic to symptomatic patients older than 20 years of age with valvular aortic stenosis. Am J Cardiol, 1988, 61(1): 123-130.
3.	Iung B, Cachier A, Baron G,et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J, 2005, 26(24): 2714-2720.
4.	Cribier A, Eltchaninoff H, Bash A,et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
5.	Holmes DJ, Mack MJ, Kaul S,et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol, 2012, 59(13): 1200-1254.
6.	Nishimura RA, Otto CM, Bonow RO,et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(23): 2440-2492.
7.	潘文志, 葛均波. 2012欧洲瓣膜性心脏病处理指南简介. 中国医学前沿杂志(电子版), 2013(2): 61-65.
8.	中国医师协会心血管内科医师分会结构性心脏病专业委员, 中华医学会心血管病学分会结构性心脏病学组. 经导管主动脉瓣置换术中国专家共识. 中国介入心脏病学杂志, 2015, 23(12): 661-667.
9.	D'Errigo P, Barbanti M, Ranucci M,et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: results from an intermediate risk propensity-matched population of the Italian OBSERVANT study. Int J Cardiol, 2013, 167(5): 1945-1952.
10.	Tamburino C, Barbanti M, D'Errigo P,et al. 1-Year Outcomes After Transfemoral Transcatheter or Surgical Aortic Valve Replacement: Results From the Italian OBSERVANT Study. J Am Coll Cardiol, 2015, 66(7): 804-812.
11.	Thyregod HG, Steinbruchel DA, Ihlemann N,et al. Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial. J Am Coll Cardiol, 2015, 65(20): 2184-2194.
12.	Piazza N, Kalesan B, van Mieghem N,et al. A 3-center comparison of 1-year mortality outcomes between transcatheter aortic valve implantation and surgical aortic valve replacement on the basis of propensity score matching among intermediate-risk surgical patients. JACC Cardiovasc Interv, 2013, 6(5): 443-451.
13.	Mack MJ, Leon MB, Smith CR,et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
14.	Takagi H, Niwa M, Mizuno Y,et al. A meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement. Ann Thorac Surg, 2013, 96(2): 513-519.
15.	Wu YC, Zhang JF, Shen WF,et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis. Chin Med J (Engl), 2013, 126(6): 1171-1177.
16.	Reardon MJ, Adams DH, Kleiman NS,et al. 2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement. J Am Coll Cardiol, 2015, 66(2): 113-121.
17.	Reardon MJ, Kleiman NS, Adams DH,et al. Outcomes in the Randomized CoreValve US Pivotal High Risk Trial in Patients With a Society of Thoracic Surgeons Risk Score of 7% or Less. JAMA Cardiol, 2016, 1(8): 945-949.
18.	Ailawadi G, LaPar DJ, Speir AM,et al. Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis. Ann Thorac Surg, 2016, 101(1): 154-160.
19.	Reynolds MR, Magnuson EA, Wang K,et al. Health-related quality of life after transcatheter or surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results from the PARTNER (Placement of AoRTic TraNscathetER Valve) Trial (Cohort A). J Am Coll Cardiol, 2012, 60(6): 548-558.
20.	Dvir D, Waksman R, Barbash IM,et al. Outcomes of patients with chronic lung disease and severe aortic stenosis treated with transcatheter versus surgical aortic valve replacement or standard therapy: insights from the PARTNER trial (placement of AoRTic TraNscathetER Valve). J Am Coll Cardiol, 2014, 63(3): 269-279.
21.	Lindman BR, Pibarot P, Arnold SV,et al. Transcatheter versus surgical aortic valve replacement in patients with diabetes and severe aortic stenosis at high risk for surgery: an analysis of the PARTNER Trial (Placement of Aortic Transcatheter Valve). J Am Coll Cardiol, 2014, 63(11): 1090-1099.
22.	Barbanti M, Webb JG, Hahn RT,et al. Impact of preoperative moderate/severe mitral regurgitation on 2-year outcome after transcatheter and surgical aortic valve replacement: insight from the Placement of Aortic Transcatheter Valve (PARTNER) Trial Cohort A. Circulation, 2013, 128(25): 2776-2784.
23.	Conte JV, Gleason TG, Resar JR,et al. Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting. Ann Thorac Surg, 2016, 101(1): 72-79.
24.	Elmariah S, Palacios IF, McAndrew T,et al. Outcomes of transcatheter and surgical aortic valve replacement in high-risk patients with aortic stenosis and left ventricular dysfunction: results from the Placement of Aortic Transcatheter Valves (PARTNER) trial (cohort A). Circ Cardiovasc Interv, 2013, 6(6): 604-614.
25.	Onorati F, D'Errigo P, Grossi C,et al. Effect of severe left ventricular systolic dysfunction on hospital outcome after transcatheter aortic valve implantation or surgical aortic valve replacement: results from a propensity-matched population of the Italian OBSERVANT multicenter study. J Thorac Cardiovasc Surg, 2014, 147(2): 568-575.
26.	Pibarot P, Weissman NJ, Stewart WJ,et al. Incidence and sequelae of prosthesis-patient mismatch in transcatheter versus surgical valve replacement in high-risk patients with severe aortic stenosis: a PARTNER trial cohort——a analysis. J Am Coll Cardiol, 2014, 64(13): 1323-1334.
27.	Hahn RT, Pibarot P, Stewart WJ,et al. Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (placement of aortic transcatheter valves). J Am Coll Cardiol, 2013, 61(25): 2514-2521.
28.	Onorati F, D'Errigo P, Barbanti M,et al. Results differ between transaortic and open surgical aortic valve replacement in women. Ann Thorac Surg, 2013, 96(4): 1336-1342.

1. Nishimura RA, Otto CM, Bonow RO,et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2014, 148(1): e1-e132.
2. Kelly TA, Rothbart RM, Cooper CM,et al. Comparison of outcome of asymptomatic to symptomatic patients older than 20 years of age with valvular aortic stenosis. Am J Cardiol, 1988, 61(1): 123-130.
3. Iung B, Cachier A, Baron G,et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J, 2005, 26(24): 2714-2720.
4. Cribier A, Eltchaninoff H, Bash A,et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
5. Holmes DJ, Mack MJ, Kaul S,et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol, 2012, 59(13): 1200-1254.
6. Nishimura RA, Otto CM, Bonow RO,et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 2014, 129(23): 2440-2492.
7. 潘文志, 葛均波. 2012欧洲瓣膜性心脏病处理指南简介. 中国医学前沿杂志(电子版), 2013(2): 61-65.
8. 中国医师协会心血管内科医师分会结构性心脏病专业委员, 中华医学会心血管病学分会结构性心脏病学组. 经导管主动脉瓣置换术中国专家共识. 中国介入心脏病学杂志, 2015, 23(12): 661-667.
9. D'Errigo P, Barbanti M, Ranucci M,et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: results from an intermediate risk propensity-matched population of the Italian OBSERVANT study. Int J Cardiol, 2013, 167(5): 1945-1952.
10. Tamburino C, Barbanti M, D'Errigo P,et al. 1-Year Outcomes After Transfemoral Transcatheter or Surgical Aortic Valve Replacement: Results From the Italian OBSERVANT Study. J Am Coll Cardiol, 2015, 66(7): 804-812.
11. Thyregod HG, Steinbruchel DA, Ihlemann N,et al. Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial. J Am Coll Cardiol, 2015, 65(20): 2184-2194.
12. Piazza N, Kalesan B, van Mieghem N,et al. A 3-center comparison of 1-year mortality outcomes between transcatheter aortic valve implantation and surgical aortic valve replacement on the basis of propensity score matching among intermediate-risk surgical patients. JACC Cardiovasc Interv, 2013, 6(5): 443-451.
13. Mack MJ, Leon MB, Smith CR,et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
14. Takagi H, Niwa M, Mizuno Y,et al. A meta-analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement. Ann Thorac Surg, 2013, 96(2): 513-519.
15. Wu YC, Zhang JF, Shen WF,et al. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis. Chin Med J (Engl), 2013, 126(6): 1171-1177.
16. Reardon MJ, Adams DH, Kleiman NS,et al. 2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement. J Am Coll Cardiol, 2015, 66(2): 113-121.
17. Reardon MJ, Kleiman NS, Adams DH,et al. Outcomes in the Randomized CoreValve US Pivotal High Risk Trial in Patients With a Society of Thoracic Surgeons Risk Score of 7% or Less. JAMA Cardiol, 2016, 1(8): 945-949.
18. Ailawadi G, LaPar DJ, Speir AM,et al. Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis. Ann Thorac Surg, 2016, 101(1): 154-160.
19. Reynolds MR, Magnuson EA, Wang K,et al. Health-related quality of life after transcatheter or surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results from the PARTNER (Placement of AoRTic TraNscathetER Valve) Trial (Cohort A). J Am Coll Cardiol, 2012, 60(6): 548-558.
20. Dvir D, Waksman R, Barbash IM,et al. Outcomes of patients with chronic lung disease and severe aortic stenosis treated with transcatheter versus surgical aortic valve replacement or standard therapy: insights from the PARTNER trial (placement of AoRTic TraNscathetER Valve). J Am Coll Cardiol, 2014, 63(3): 269-279.
21. Lindman BR, Pibarot P, Arnold SV,et al. Transcatheter versus surgical aortic valve replacement in patients with diabetes and severe aortic stenosis at high risk for surgery: an analysis of the PARTNER Trial (Placement of Aortic Transcatheter Valve). J Am Coll Cardiol, 2014, 63(11): 1090-1099.
22. Barbanti M, Webb JG, Hahn RT,et al. Impact of preoperative moderate/severe mitral regurgitation on 2-year outcome after transcatheter and surgical aortic valve replacement: insight from the Placement of Aortic Transcatheter Valve (PARTNER) Trial Cohort A. Circulation, 2013, 128(25): 2776-2784.
23. Conte JV, Gleason TG, Resar JR,et al. Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting. Ann Thorac Surg, 2016, 101(1): 72-79.
24. Elmariah S, Palacios IF, McAndrew T,et al. Outcomes of transcatheter and surgical aortic valve replacement in high-risk patients with aortic stenosis and left ventricular dysfunction: results from the Placement of Aortic Transcatheter Valves (PARTNER) trial (cohort A). Circ Cardiovasc Interv, 2013, 6(6): 604-614.
25. Onorati F, D'Errigo P, Grossi C,et al. Effect of severe left ventricular systolic dysfunction on hospital outcome after transcatheter aortic valve implantation or surgical aortic valve replacement: results from a propensity-matched population of the Italian OBSERVANT multicenter study. J Thorac Cardiovasc Surg, 2014, 147(2): 568-575.
26. Pibarot P, Weissman NJ, Stewart WJ,et al. Incidence and sequelae of prosthesis-patient mismatch in transcatheter versus surgical valve replacement in high-risk patients with severe aortic stenosis: a PARTNER trial cohort——a analysis. J Am Coll Cardiol, 2014, 64(13): 1323-1334.
27. Hahn RT, Pibarot P, Stewart WJ,et al. Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (placement of aortic transcatheter valves). J Am Coll Cardiol, 2013, 61(25): 2514-2521.
28. Onorati F, D'Errigo P, Barbanti M,et al. Results differ between transaortic and open surgical aortic valve replacement in women. Ann Thorac Surg, 2013, 96(4): 1336-1342.

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