Clinical Outcomes of Transcatheter Mitral Valve-In-Valve and Valve-In-Ring Implantation: A Systematic Review and Meta-Analysis.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-11-20 DOI:10.1002/ccd.31299

Khi Yung Fong, John Ming Yan Koh, Lip Wei Saw, Devy Anggreni, Ethel Zi Xie Ng, Yiong Huak Chan, Karl Poon, Dion Stub, Shih-Hsien Sung, Mann Chandavimol, Michael Kang-Yin Lee, Angus Shing Fung Chui, A B Gopalamurugan, Rajesh Nair, Yingqiang Guo, Mohammed Rizwan Amanullah, Victor Tar Toong Chao, See Hooi Ewe, Kay Woon Ho, Jonathan Yap

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引用次数: 0

Abstract

Background: Transcatheter valve-in-valve (VIV) or valve-in-ring (VIR) therapies for degenerated mitral bioprosthetic valves and rings are still evolving. We aimed to characterize short- and long-term outcomes of these procedures.

Methods: An electronic literature search was conducted to retrieve articles describing mitral VIV or VIR implantation with at least 10 patients. Meta-analysis of proportions was carried out for 30-day or in-hospital outcomes of mortality, stroke, major bleeding, transfusion, acute kidney injury, procedural success, valve embolization, paravalvular leak, pacemaker implantation, and hospital stay. Individual patient data meta-analysis using Kaplan-Meier curve reconstruction was used to estimate long-term mortality of VIV, VIR and redo surgical mitral valve replacement (SMVR).

Results: We analyzed 34 studies (7047 patients). Pooled procedural success was 94.8% in VIV and 80.5% in VIR. Pooled short-term mortality and stroke risk was 6.4% and 1.9% respectively in VIV, 9.1% and 1.6% respectively in VIR, and 8.4% and 5.5% respectively in SMVR.

Conclusions: This study provides prognostic information on clinical outcomes for redo SMVR and transcatheter mitral VIV and VIR implantation.

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经导管二尖瓣瓣中瓣和瓣环植入术的临床结果：系统综述与元分析》。

背景：经导管瓣中瓣（VIV）或瓣环中瓣（VIR）治疗退化的二尖瓣生物人工瓣膜和瓣环的方法仍在不断发展。我们旨在描述这些手术的短期和长期疗效：我们进行了电子文献检索，检索了至少有 10 名患者接受过二尖瓣 VIV 或 VIR 植入术的文章。对30天或住院期间的死亡率、中风、大出血、输血、急性肾损伤、手术成功率、瓣膜栓塞、瓣膜旁漏、起搏器植入和住院时间等结果进行了比例荟萃分析。采用Kaplan-Meier曲线重建法对患者个体数据进行荟萃分析，以估算VIV、VIR和重做手术二尖瓣置换术（SMVR）的长期死亡率：我们分析了 34 项研究（7047 名患者）。VIV的汇总手术成功率为94.8%，VIR为80.5%。VIV的汇总短期死亡率和中风风险分别为6.4%和1.9%，VIR分别为9.1%和1.6%，SMVR分别为8.4%和5.5%：这项研究提供了重做 SMVR 和经导管二尖瓣 VIV 和 VIR 植入术的临床预后信息。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.