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Short-Term, Mid-Term, and Long-Term Outcomes of Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expanding Valves: A Meta-Analysis of Randomized Controlled Trials Publisher Pubmed



Tavakoli K1 ; Mohammadi NSH1 ; Bahiraie P2 ; Saeidi S1 ; Shaker F1 ; Moghadam AS1 ; Namin SM1 ; Rahban H3, 4 ; Pawar S5 ; Tajdini M1, 6 ; Soleimani H1, 6 ; Jenab Y1, 6 ; Ahmad Y7 ; Iskander FH8 Show All Authors
Authors
  1. Tavakoli K1
  2. Mohammadi NSH1
  3. Bahiraie P2
  4. Saeidi S1
  5. Shaker F1
  6. Moghadam AS1
  7. Namin SM1
  8. Rahban H3, 4
  9. Pawar S5
  10. Tajdini M1, 6
  11. Soleimani H1, 6
  12. Jenab Y1, 6
  13. Ahmad Y7
  14. Iskander FH8
  15. Alkhouli M9
  16. Makkar R5
  17. Gupta A5
  18. Hosseini K1, 6
Show Affiliations
Authors Affiliations
  1. 1. Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Cardiovascular Research Foundation of Southern California, Beverly Hills, CA, United States
  4. 4. Department of Cardiovascular Disease, Creighton University School of Medicine, St. Joseph Hospital and Medical Center, Phoenix, AZ, United States
  5. 5. Cedars Sinai Medical Center, California, United States
  6. 6. Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Yale School of Medicine, Yale University, New Haven, CT, United States
  8. 8. Department of Cardiology, Medstar Union Memorial Hospital, Baltimore, MD, United States
  9. 9. Department of Cardiology, Mayo Clinic School of Medicine, Rochester, MN, United States

Source: Clinical Cardiology Published:2025


Abstract

Background: Comparisons of outcomes after transcatheter aortic valve replacement with balloon-expandable (BEV) versus self-expanding (SEV) valves are limited. Hypothesis: This study aimed to compare clinical and hemodynamic outcomes of BEV and SEV at short-term (30 days), midterm (1 year), and long-term (> 1 year) endpoints. Methods: PubMed, Embase, Scopus, and Cochrane Library databases were searched until July 2024 for randomized controlled trials. Random-effect model (DerSimonian–Laird method) was used to pool the risk ratios (RR), mean differences, and 95% confidence intervals (CI). Results: A total of 10 studies comprising 4325 patients (2295 BEV, 2030 SEV) were included. In short-term, cardiovascular (RR: 0.56, 95% CI: 0.36–0.87) and all-cause mortality (RR: 0.54, 95% CI: 0.35–0.81) were lower in the BEV group. Risk of moderate to severe paravalvular leak (PVL) was lower among BEV patients in short-term (RR: 0.28, 95% CI: 0.17–0.49) and long-term (RR: 0.28, 95% CI: 0.1–0.79). A limited number of studies showed a greater risk of clinical valve thrombosis on BEV in midterm and long-term. The need for permanent pacemaker implantation was lower in BEV at both short-term (RR: 0.56, 95% CI: 0.37–0.87), and midterm (RR: 0.78, 95% CI: 0.64–0.94). The SEV group had a larger effective orifice area with lower mean transvalvular pressure gradient at all endpoints. Conclusions: BEV is associated with reduced risk of clinical outcomes in short-term; however, most differences diminish in longer evaluations, except for moderate to severe PVL, which remains elevated for SEV. SEVs had better hemodynamic results and lower risk of clinical valve thrombosis. © 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals, LLC.
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