The following is a summary of “Comparison of outcomes of self-expanding versus balloon-expandable valves for transcatheter aortic valve replacement: a meta-analysis of randomized and propensity-matched studies,” published in the July 2023 issue of Cardiology by Wang et al.
Uncertain Postoperative Outcomes of Transcatheter Aortic Valve Replacement (TAVR) with new generation Self-Expanding Valves (SEV) & Balloon-Expandable Valves (BEV).
Researchers performed a retrospective study and evaluated the performance of new generation TAVR devices, including Edwards SAPIEN 3/Ultra BEV, Medtronic Evolut R/PRO SEV, and Boston ACURATE neo-SEV, through a meta-analysis of randomized controlled trials (RCTs) & propensity score-matched (PSM) studies. Mortality & complications were assessed at 30 days & 1-year post-operation as the primary endpoints.
The results showed 4 RCTs and 14 propensity score-matched (PSM) studies. Analysis shows no significant difference in 30-day and 1-year mortality rates between SEV & BEV. ACURATE SEV had fewer permanent pacemaker implantations (PPI) at 30 days compared to SAPIEN BEV, while Evolut SEV had a higher PPI rate than SAPIEN BEV. There were no notable variations observed in the incidence of stroke, major or life-threatening bleeding (MLTB), major vascular complications (MVC), coronary artery obstruction (CAO), and acute kidney injury (AKI) between the two groups. SEV exhibited a larger effective orifice area (EOA) and lower mean transvalvular gradients (MPG) than BEV. SEV was linked to higher paravalvular leakage (PVL) risk.
They concluded Evolut SEV and SAPIEN BEV showed comparability in 30-day mortality, stroke, bleeding, and 1-year mortality.