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Long term outcomes of transcatheter aortic valve implantation (TAVI): a systematic review of 5-year survival and beyond

  
@article{ACS16396,
	author = {Adam Chakos and Ashley Wilson-Smith and Sameer Arora and Tom C. Nguyen and Abhijeet Dhoble and Giuseppe Tarantini and Matthias Thielmann and John P. Vavalle and Daniel Wendt and Tristan D. Yan and David H. Tian},
	title = {Long term outcomes of transcatheter aortic valve implantation (TAVI): a systematic review of 5-year survival and beyond},
	journal = {Annals of Cardiothoracic Surgery},
	volume = {6},
	number = {5},
	year = {2017},
	keywords = {},
	abstract = {Background: Transcatheter aortic valve implantation/replacement (TAVI/TAVR) is becoming more frequently used to treat aortic stenosis (AS), with increasing push for the procedure in lower risk patients. Numerous randomized controlled trials have demonstrated that TAVI offers a suitable alternative to the current gold standard of surgical aortic valve replacement (SAVR) in terms of short-term outcomes. The present review evaluates long-term outcomes following TAVI procedures.
Methods: Literature search using three electronic databases was performed up to June 2017. Studies which included 20 or more patients undergoing TAVI procedures, either as a stand-alone or concomitant procedure and with a follow-up of at least 5 years, were included in the present review. Literature search and data extraction were performed by two independent researchers. Digitized survival data were extracted from Kaplan-Meier curves in order to re-create the original patient data using an iterative algorithm and subsequently aggregated for analysis.
Results: Thirty-one studies were included in the present analysis, with a total of 13,857 patients. Two studies were national registries, eight were multi-institutional collaborations and the remainder were institutional series. Overall, 45.7% of patients were male, with mean age of 81.5±7.0 years. Where reported, the mean Logistic EuroSCORE (LES) was 22.1±13.7 and the mean Society of Thoracic Surgeons (STS) score was 9.2±6.6. The pooled analysis found 30-day mortality, cerebrovascular accidents, acute kidney injury (AKI) and requirement for permanent pacemaker (PPM) implantation to be 8.4%, 2.8%, 14.4%, and 13.4%, respectively. Aggregated survival at 1-, 2-, 3-, 5- and 7-year were 83%, 75%, 65%, 48% and 28%, respectively.
Conclusions: The present systematic review identified acceptable long-term survival results for TAVI procedures in an elderly population. Extended follow-up is required to assess long-term outcomes following TAVI, particularly before its application is extended into wider population groups.},
	issn = {2225-319X},	url = {http://www.annalscts.com/article/view/16396}
}