TY  - JOUR
AU  - Chakos, Adam
AU  - Wilson-Smith, Ashley
AU  - Arora, Sameer
AU  - Nguyen, Tom C.
AU  - Dhoble, Abhijeet
AU  - Tarantini, Giuseppe
AU  - Thielmann, Matthias
AU  - Vavalle, John P.
AU  - Wendt, Daniel
AU  - Yan, Tristan D.
AU  - Tian, David H.
PY  - 2017
TI  - Long term outcomes of transcatheter aortic valve implantation (TAVI): a systematic review of 5-year survival and beyond
JF  - Annals of Cardiothoracic Surgery; Vol 6, No 5 (September 30, 2017): Transcatheter Aortic Valve Implantation
Y2  - 2017
KW  - 
N2  - 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.
UR  - https://www.annalscts.com/article/view/16396