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Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis

BACKGROUND: Whether there are differences among the new-generation transcatheter aortic valve implantation (TAVI) devices for patients with aortic stenosis remains unclear. The aim of the study was to compare the efficiency and safety of different new-generation TAVI devices for patients with aortic...

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Autores principales: Yang, Yi-Xing, Liu, Xin-Ming, Fu, Yuan, Li, Chuang, Wang, Hong-Jiang, Xu, Li, Xia, Kun, Zhang, Zhi-Yong, Zhong, Jiu-Chang, Chen, Mu-Lei, Su, Pi-Xiong, Wang, Le-Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442113/
https://www.ncbi.nlm.nih.gov/pubmed/37161443
http://dx.doi.org/10.1097/JS9.0000000000000456
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author Yang, Yi-Xing
Liu, Xin-Ming
Fu, Yuan
Li, Chuang
Wang, Hong-Jiang
Xu, Li
Xia, Kun
Zhang, Zhi-Yong
Zhong, Jiu-Chang
Chen, Mu-Lei
Su, Pi-Xiong
Wang, Le-Feng
author_facet Yang, Yi-Xing
Liu, Xin-Ming
Fu, Yuan
Li, Chuang
Wang, Hong-Jiang
Xu, Li
Xia, Kun
Zhang, Zhi-Yong
Zhong, Jiu-Chang
Chen, Mu-Lei
Su, Pi-Xiong
Wang, Le-Feng
author_sort Yang, Yi-Xing
collection PubMed
description BACKGROUND: Whether there are differences among the new-generation transcatheter aortic valve implantation (TAVI) devices for patients with aortic stenosis remains unclear. The aim of the study was to compare the efficiency and safety of different new-generation TAVI devices for patients with aortic stenosis. MATERIALS AND METHODS: A comprehensive search of PubMed, Embase and Web of Science from their inception to 1 February 2022. Randomized clinical trials and observational studies that compared two or more different TAVI devices were enroled. Pairwise meta-analysis and frequentist network meta-analysis were conducted to pool the outcome estimates of interest. RESULTS: A total of 79 studies were finally included. According to the surface under the cumulative ranking, the top two ranked valves for lower rates of events were as follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major and life-threatening bleeding; Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of mean aortic valve gradients. CONCLUSIONS: The findings of the present study suggested that the device success rates were comparable among these new-generation valves except for DFM. After excluding DFM, Sapien 3 might be the best effective for decreased mortality and stroke; Lotus might be the best effective for decreased paravalvular leak; Evolut might be the best effective for decreased major and life-threatening bleeding and mean aortic valve gradients; Acurate and Portico might be the best effective for decreased permanent pacemaker implantation and acute kidney injury, respectively.
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spelling pubmed-104421132023-08-22 Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis Yang, Yi-Xing Liu, Xin-Ming Fu, Yuan Li, Chuang Wang, Hong-Jiang Xu, Li Xia, Kun Zhang, Zhi-Yong Zhong, Jiu-Chang Chen, Mu-Lei Su, Pi-Xiong Wang, Le-Feng Int J Surg Reviews BACKGROUND: Whether there are differences among the new-generation transcatheter aortic valve implantation (TAVI) devices for patients with aortic stenosis remains unclear. The aim of the study was to compare the efficiency and safety of different new-generation TAVI devices for patients with aortic stenosis. MATERIALS AND METHODS: A comprehensive search of PubMed, Embase and Web of Science from their inception to 1 February 2022. Randomized clinical trials and observational studies that compared two or more different TAVI devices were enroled. Pairwise meta-analysis and frequentist network meta-analysis were conducted to pool the outcome estimates of interest. RESULTS: A total of 79 studies were finally included. According to the surface under the cumulative ranking, the top two ranked valves for lower rates of events were as follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major and life-threatening bleeding; Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of mean aortic valve gradients. CONCLUSIONS: The findings of the present study suggested that the device success rates were comparable among these new-generation valves except for DFM. After excluding DFM, Sapien 3 might be the best effective for decreased mortality and stroke; Lotus might be the best effective for decreased paravalvular leak; Evolut might be the best effective for decreased major and life-threatening bleeding and mean aortic valve gradients; Acurate and Portico might be the best effective for decreased permanent pacemaker implantation and acute kidney injury, respectively. Lippincott Williams & Wilkins 2023-05-10 /pmc/articles/PMC10442113/ /pubmed/37161443 http://dx.doi.org/10.1097/JS9.0000000000000456 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-sa/4.0/This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0 (https://creativecommons.org/licenses/by-sa/4.0/) , which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-sa/4.0/ (https://creativecommons.org/licenses/by-sa/4.0/)
spellingShingle Reviews
Yang, Yi-Xing
Liu, Xin-Ming
Fu, Yuan
Li, Chuang
Wang, Hong-Jiang
Xu, Li
Xia, Kun
Zhang, Zhi-Yong
Zhong, Jiu-Chang
Chen, Mu-Lei
Su, Pi-Xiong
Wang, Le-Feng
Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title_full Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title_fullStr Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title_full_unstemmed Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title_short Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
title_sort comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442113/
https://www.ncbi.nlm.nih.gov/pubmed/37161443
http://dx.doi.org/10.1097/JS9.0000000000000456
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