Indraratna Praveen, Tian David H, Yan Tristan D, Doyle Mathew P, Cao Christopher
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Department of Cardiology, St George Hospital, Sydney, Australia.
The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia.
Int J Cardiol. 2016 Dec 1;224:382-387. doi: 10.1016/j.ijcard.2016.09.018. Epub 2016 Sep 15.
Transcatheter aortic valve implantation (TAVI) has become a widely utilized method of treatment of severe aortic valve stenosis. The present meta-analysis included all published relevant randomized controlled trials (RCTs) and aimed to compare the safety and efficacy of TAVI compared to surgical aortic valve replacement (AVR).
Nine electronic databases were comprehensively searched. Eligible studies were required to be randomized controlled trials which reported comparative endpoints on both TAVI and AVR.
Five published RCTs were included in the meta-analysis. A total of 3828 patients were studied. The overall mortality and stroke rates at 30days and 1year were not significantly different between TAVI and AVR. Patients undergoing TAVI were more likely to experience vascular complications, aortic regurgitation and permanent pacemaker insertion, however, they were less likely to encounter acute renal failure and major haemorrhage.
The data suggest that TAVI is a safe and efficacious alternative to surgical aortic valve replacement in judiciously selected patients.
经导管主动脉瓣植入术（TAVI）已成为治疗严重主动脉瓣狭窄的一种广泛应用的方法。本荟萃分析纳入了所有已发表的相关随机对照试验（RCT），旨在比较TAVI与外科主动脉瓣置换术（AVR）的安全性和有效性。
全面检索了九个电子数据库。符合条件的研究必须是报告了TAVI和AVR比较终点的随机对照试验。
五项已发表的RCT被纳入荟萃分析。共研究了3828例患者。TAVI和AVR在30天和1年时的总体死亡率和卒中率无显著差异。然而，接受TAVI的患者更易发生血管并发症、主动脉瓣反流和永久性起搏器植入，而发生急性肾衰竭和大出血的可能性较小。
数据表明，在经过审慎选择的患者中，TAVI是外科主动脉瓣置换术的一种安全有效的替代方法。
