AI Article Synopsis
- A meta-analysis was conducted to compare the minimalist and standard approaches to transcatheter aortic valve replacement (TAVR) using studies up to September 2020.
- The analysis included 9 studies with 2,880 patients and found that the minimalist approach showed reduced risks for complications such as acute kidney injury, major bleeding, and major vascular issues.
- Although there were no significant differences in mortality or readmission rates, the minimalist approach resulted in shorter hospital stays, less procedural time, and lower contrast volume used.
Article Abstract
Background: The change in practice of transcatheter aortic valve replacement (TAVR) to a minimalist approach is a debate.
Methods: Online database search for studies that compared the minimalist approach with the standard approach for TAVR were searched from inception through September 2020. We calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using the fixed or random-effects model.
Results: A total of 9 studies with 2,880 TAVR patients (minimalist TAVR;1066 and standard TAVR; 1,814) were included. Compared to standard approach, there were no significant differences in in-hospital mortality, 30-day mortality, or hospital readmissions. However, there was a reduced risk of acute kidney injury (OR0.49;95%CI0.27-0.89), major bleeding (OR0.21;95%CI0.12-0.38) and major vascular complications (OR0.60,95%CI0.39-0.91) associated with the minimalist TAVR group. There was comparatively shorter hospital length of stay (mean difference -2.41;95%CI-2.99,-1.83) days, procedural time (mean difference -43.99;95%CI-67.25,-20.75) minutes, fluoroscopy time (mean difference -2.69;95%CI-3.44,-1.94) minutes and contrast volume (mean difference -26.98;95%CI-42.18,-11.79) ml in the minimalist TAVR group.
Conclusions: This meta-analysis demonstrated potential benefits of the minimalist TAVR approach over the standard approach regarding some adverse clinical outcomes as well as procedural outcomes without significant differences in mortality or readmission rates.
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| http://dx.doi.org/10.1080/14779072.2021.1920926 | DOI Listing |
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