Valve in valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-Surgical aortic valve replacement (redo-SAVR): A systematic review and meta-analysis

Authors

• Nikhil Nalluri, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Varunsiri Atti, Department of Internal Medicine, Michigan State University, Sparrow Hospital, East Lansing, Michigan.
• Abdullah B. Munir, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Boutros Karam, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Nileshkumar J. Patel, Department of Cardiology, University of Miami, Jackson Memorial Hospital, Miami, Florida.
• Varun Kumar, Department of Cardiology, Mount Sinai St. Luke's Roosevelt Hospital, New York City, New York.
• Praveen Vemula, Department of Internal Medicine, Sparrow Health System, Lansing, Michigan.
• Sushruth Edla, Department of Cardiology, St. John Hospital and Medical Center, Detroit, Michigan.
• Deepak Asti, Department of Interventional Cardiology, Lenox Hill Hospital, Northwell Health, Manhattan, New York City, New York.
• Amrutha Paturu, Department of Internal Medicine, NRI Medical College, Guntur, India.
• Sriramya Gayam, Department of Internal Medicine, KVG Medical College, Sullia, Karnataka, India.
• Jonathan Spagnola, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Emad Barsoum, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Gregory A. Maniatis, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Frank Tamburrino, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Ruben Kandov, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• James Lafferty, Department of Cardiology, Staten Island University Hospital, Northwell Health, Staten Island, New York City, New York.
• Chad Kliger, Department of Interventional Cardiology, Lenox Hill Hospital, Northwell Health, Manhattan, New York City, New York.

Document Type

Article

Abstract

BACKGROUND: Bioprosthetic (BP) valves have been increasingly used for aortic valve replacement over the last decade. Due to their limited durability, patients presenting with failed BP valves are rising. Valve in Valve - Transcatheter Aortic Valve Implantation (ViV-TAVI) emerged as an alternative to the gold standard redo-Surgical Aortic Valve Replacement (redo-SAVR). However, the utility of ViV-TAVI is poorly understood. METHODS: A systematic electronic search of the scientific literature was done in PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov. Only studies which compared the safety and efficacy of ViV-TAVI and redo-SAVR head to head in failed BP valves were included. RESULTS: Six observational studies were eligible and included 594 patients, of whom 255 underwent ViV- TAVI and 339 underwent redo-SAVR. There was no significant difference between ViV-TAVI and redo- SAVR for procedural, 30 day and 1 year mortality rates. ViV-TAVI was associated with lower risk of permanent pacemaker implantation (PPI) (OR: 0.43, CI: 0.21-0.89; P = 0.02) and a trend toward increased risk of paravalvular leak (PVL) (OR: 5.45, CI: 0.94-31.58; P = 0.06). There was no significant difference for stroke, major bleeding, vascular complications and postprocedural aortic valvular gradients more than 20 mm-hg. CONCLUSION: Our results reiterate the safety and feasibility of ViV-TAVI for failed aortic BP valves in patients deemed to be at high risk for surgery. VIV-TAVI was associated with lower risk of permanent pacemaker implantation with a trend toward increased risk of paravalvular leak.

Medical Subject Headings

Aortic Valve (surgery); Aortic Valve Stenosis (surgery); Heart Valve Prosthesis Implantation (adverse effects, instrumentation, methods); Humans; Postoperative Complications (etiology, therapy); Prosthesis Design; Transcatheter Aortic Valve Replacement (adverse effects, instrumentation, methods); Treatment Outcome

Publication Date

10-1-2018

Publication Title

Journal of interventional cardiology

E-ISSN

1540-8183

Volume

31

Issue

5

First Page

661

Last Page

671

PubMed ID

29781182

Digital Object Identifier (DOI)

10.1111/joic.12520

Recommended Citation

Nalluri, Nikhil; Atti, Varunsiri; Munir, Abdullah B.; Karam, Boutros; Patel, Nileshkumar J.; Kumar, Varun; Vemula, Praveen; Edla, Sushruth; Asti, Deepak; Paturu, Amrutha; Gayam, Sriramya; Spagnola, Jonathan; Barsoum, Emad; Maniatis, Gregory A.; Tamburrino, Frank; Kandov, Ruben; Lafferty, James; and Kliger, Chad, "Valve in valve transcatheter aortic valve implantation (ViV-TAVI) versus redo-Surgical aortic valve replacement (redo-SAVR): A systematic review and meta-analysis" (2018). Neurology. 2095.
https://scholar.barrowneuro.org/neurology/2095