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Published on: June 3, 2018
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Post-dilation in transcatheter aortic valve replacement: A systematic review and meta-analysis
Nelson Wang1,2, Sean Lal1,2
1University of Sydney, Sydney, New South Wales, Australia.
Journal of Interventional Cardiology
|March 22, 2017
Summary
Balloon post-dilation (PD) in transcatheter aortic valve replacement (TAVR) significantly reduces paravalvular regurgitation (PVR). However, PD increases stroke risk, necessitating careful patient selection for optimal TAVR outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Balloon post-dilation (PD) is frequently employed during transcatheter aortic valve replacement (TAVR) procedures.
- Its primary goal is to mitigate paravalvular regurgitation (PVR), despite limited supporting evidence.
Purpose of the Study:
- To conduct a meta-analysis comparing TAVR outcomes with and without PD.
- To evaluate the efficacy and safety of PD in TAVR patients.
Main Methods:
- Systematic review and meta-analysis of 6 studies.
- Comparison of 889 patients who underwent PD versus 4118 patients who did not.
Main Results:
- PD significantly reduced moderate-to-severe PVR (OR 15.0).
- Patients receiving PD had a higher incidence of stroke (OR 1.71).
- No significant differences were observed in 30-day or 1-year mortality, or myocardial infarction rates.
Conclusions:
- PD effectively improves PVR rates in TAVR.
- Careful patient selection is crucial to minimize the increased risk of stroke associated with PD.
