Single-arm Meta-analysis of Argentine Studies Reporting 30-Day Mortality After Transcatheter Aortic Valve Implantation in Intermediate Risk Patients

Raul Borracci, Eugenia Amrein, Claudio C. Higa


Background: Transcatheter aortic valve implantation (TAVI) has been shown to be beneficial in patients with intermediaterisk; however, there is no overall analysis reporting TAVI results in our country.Objectives: To conduct a single-arm meta-analysis of local studies reporting 30-day outcomes after TAVI in intermediate riskpatients in Argentina.Methods: A systematic review on TAVI was performed using controlled trials and observational studies identified in MEDLINE,Embase, SCOPUS and Cochrane to August 2019.Results: Among 59 articles identified through the database search, only 4 local observational studies reported 30-day mortalityand complications after TAVI in moderate-risk patients according to the STS (Society of Thoracic Surgeons) score rangingbetween 4 and 7%. In 494 patients, 30-day mortality was 4.8%. Weighted pooled estimates of the studies were: stroke 2.7%,myocardial infarction 1.0%, need for a definitive pacemaker 24.8%, moderate or severe periprosthetic leakage 16.7%, andmajor bleeding 5.5%.Conclusions: The proven efficacy of TAVI is generating an expansion of its indication to patients with intermediate and lowrisk, However, this shift should be supported by local evidence of its benefit over traditional valve surgery. This single-armmeta-analysis of Argentine studies presents 30-day mortality and complications after TAVI in intermediate risk patients. Theupdated information of the local TAVI outcomes will serve as a standard in our settings.


Kapadia SR, Leon MB, Makkar RR,Tuzcu EM, Svensson LG, Kodali

S, et al. 5-year outcomes of transcatheter aortic valve replacement

compared with standard treatment for patients with inoperable

aortic stenosis (PARTNER 1B): a randomized controlled trial. Lancet


Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM,

et al. 5-year outcomes of transcatheter aortic valve replacement or

surgical aortic valve replacement for high surgical risk patients with

aortic stenosis (PARTNER 1A): a randomized controlled trial. Lancet


Deeb GM, Reardon MJ, Chetcuti S, Patel HJ, Grossman PM,

Yakubov SJ, et al. 3-year outcomes in high-risk patients who underwent surgical or transcatheter aortic valve replacement. J Am Coll Cardiol 2016;67:2565- 74.

Leon MB, Smith CR, Mack MJ,Makkar RR, Svensson LG, Kodali

SK, et al. Transcatheter or surgical aortic-valve replacement in

intermediate-risk patients. N Engl J Med 2016;374:1609-20.http://

Thourani VH, Kodali S, Makkar RR ,Herrmann HC, Williams M,

Babaliaros V, et al. Transcatheteraortic valve replacement versus

surgical valve replacement inintermediate-risk patients: a propensity

score analysis. Lancet 2016;387:2218-25.


Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, SøndergaardL, Mumtaz M, et al.; SURTAVI Investigators. Surgical

or transcatheter aortic-valve replacement in intermediate-risk

patients. N Engl J Med 2017;376:1321-31.


Mack MJ, Leon MB, Thourani VH,Makkar R, Kodali SK, Russo

M, et al. Transcatheteraortic-valve replacement with a balloon-expandable expandable

valve in lowriskpatients. N Engl J Med 2019;380:1695-705.

Popma JJ, Deeb GM, Yakubov SJ,Mumtaz M, Gada H, O’Hair D,et al. Transcatheteraortic valve replacement with a self-expanding valve in low-riskpatients. N Engl J Med 2019;380:1706-15.

Baumgartner H, Falk V, Bax JJ,De Bonis M, Hamm C, Holm PJ,

et al. 2017 ESC/EACTSguidelines for the management of valvular

heart disease. EurHeart J 2017;38:2739-91. 10.1093/eurheartj/ehx391.

Borracci RA, Navia DO, Kotowicz V, Machain A, Higa CC. Single-

Arm Meta-Analysis of Argentine Studies Reporting In-Hospital-

Mortality After Aortic Valve Replacement in Low and Intermediate

Risk Patients. Rev Argent Cardiol 2019;87:271-80. http://dx.doi.


Phan K, Tian DH, Cao C, Black D, Yan TD. Systematic review and meta-analysis : technique and a guide for the academic surgeon. AnnCardiothorac Surg 2015;4:112-22.

Fava C, Gamboa P, Caponi G, Gómez C, Fabián S, Guevara E, et al. Minimalist Approach for Percutaneous Aortic Valve Implantation.Rev Argent Cardiol 2019;87: 265-70.


Raleigh JV, Agatiello C, Romeo F, Oberti P, Falconi M, Battellini

R, et al. Transapical and Transfemoral Aortic Valve Implantation.

Impact and General Considerations of both Approaches. Rev Argent

Cardiol 2018;86:171-6.

Abud MA, Nau G, Candiello A, Padilla LT, Piccinini F, Trivi M, et

al. Efficacy and Safety of Transfemoral Transcatheter Aortic Valve

Replacement under General Anesthesia versus Local Anesthesia with Conscious Sedation. Rev Argent Cardiol 2018;86:33-9.

Cigalini IM, Zaidel EJ, Villareal R, Bettinotti M, Sosa Liprandi

A, Sztejfman M. In-Hospital and 30-Day Mortality After Percutaneous Aortic Valve Implantation. Usefulness of Different Surgical Risk Scores. Rev Argent Cardiol 2019;87:152-4.

Krasopoulos G, Falconieri F, Benedetto U, Newton J, Sayeed

R, Kharbanda R, et al. European real world trans-catheter aortic

valve implantation: systematic review and meta-analysis of European national registries. J Cardiothorac Surg 2016;11:159.

Singh K, Carson K, Rashid MK, Jayasinghe R, AlQahtani A, Dick A, et al.Transcatheter Aortic Valve Implantation in Intermediate

Surgical Risk Patients With Severe Aortic Stenosis: A Systematic

Review and Meta-Analysis. Heart Lung Circ 2018;27:227-34. http://

Lunardi M, Pesarini G, Zivelonghi C, Piccoli A, Geremia G, Ariotti S, et al. Clinical outcomes of transcatheter aortic valve implantation: from learning curve to proficiency. Open Heart 2016;3:e000420. /10.1136/openhrt-2016-000420.

Handa N, Kumamaru H, Torikai K, Kohsaka S, Takayama

M, Kobayashi J, et al.;Japanese TAVR Registry Participants.Learning Curve for Transcatheter Aortic Valve Implantation Under a Controlled Introduction System- Initial Analysis of a Japanese Nationwide Registry. Circ J 2018;82:1951-8. d

Arai T, Lefèvre T, Hovasse T, Hayashida K, Watanabe Y, O’Connor SA, et al. Evaluation of the learning curve for transcatheter aorticvalve implantation via the transfemoral approach. Int J Cardiol 2016;203:491-7. /10.1016/j.ijcard.2015.10.178.

von Scheidt W, Welz A, Pauschinger M, Fischlein T, Schächinger V, Treede H, et al. Interdisciplinary consensus on indicationsfor transfemoral transcatheter aortic valve implantation

(TF-TAVI): Joint Consensus Document of the Arbeitsgemeinschaft

Leitende Kardiologische Krankenhausärzte e.V.

(ALKK) and cooperating Cardiac Surgery Departments. Clin

Res Cardiol 2019 Aug 13.


Capodanno D, Petronio AS, Prendergast B, Eltchaninoff H, Vahanian A, Modine T, et al. Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions(EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2017;38:3382-90. 10.1093/eurheartj/ehx303.

Lancelotti P, Martinez C, Radermecker M. The long quest for the

holy grail in transcatheter aortic bioprosthesis. J Am Coll Cardiol

;73:554-8. 10.1016/j.jacc.2018.11.043.

Barbanti M, Petronio AS, Ettori F, Latib A, Bedogni F, De Marco

F,et al. 5-Year outcomes after transcatheter aortic valve implantation

with CoreValveprosthesis. J Am Coll Cardiol Interv 2015;8:1084-91.

Eltchaninoff H, Durand E, Avinée G, Tron C, Litzler PY, Bauer

F, et al. Assessment of structural valve deterioration of transcatheter

aortic bioprosthetic balloon-expandable valves using the new European Consensus definition. EuroIntervention 2018;14:e264-71.

Blackman DJ, Saraf S, MacCarthy PA, Myat A, Anderson

SG, Malkin CJ, et al. Long-term durability of transcatheter aortic

valve prostheses. J Am Coll Cardiol 2019;73:537-45. http://dx.doi.

org/ 10.1016/j.jacc.2018.10.078.

Full Text


  • There are currently no refbacks.

Licencia Creative Commons
The documents published in this journal are under the licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.

Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020