Comparative Outcomes of Self-Expanding Versus Balloon-Expandable Valves in Severe Aortic Stenosis: A Systematic Review and Meta-Analysis
Ahmed Elazab, Ahmed Hamdy G. Ali, Ahmed Elbataa, Ahmed Mansour, Noha Hammad, Amr Galal, Osama Ahmed Abdelaziz, Mohamed Saad Sayed, Mohamed Hamouda Elkasaby, Marwa Shaaban, Mohammed Sabri Hassanin, Ahella Ismail A. Mousa, Islam Y. Elgendy, Mo’ath Alharasees, Ahmed Aly, Adham Khaled Ahmad Alali, William H. Frishman, Wilbert S. Aronow
Abstract:
Abstract:
Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis, with self-expanding valves (SEV) and balloon-expandable valves (BEV) representing the two major platforms. However, their comparative clinical and hemodynamic performance remains uncertain. We systematically searched four electronic databases through August 202
6
for studies comparing SEV and BEV in patients undergoing TAVR. The primary outcomes were permanent pacemaker implantation (PPI) and change in mean pressure gradient (MPG), while secondary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), stroke, paravalvular leakage (PVL), heart failure hospitalization, coronary obstruction, and prosthesis-patient mismatch (PPM). Twenty-three studies involving 21,60
9
patients were included. Compared with BEV, SEV was associated with a significantly greater reduction in MPG (MD −4.
48
, 95% CI −5.29 to −3.67;