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Purpose <p>If patients with bicuspid aortic valve (BAV) stenosis are high-risk candidates for traditional open-heart surgery, they can be treated with transcatheter aortic valve replacement (TAVR). The purpose of this study is to understand the effects of balloon-expandable valves (BEVs) and self-expandable valves (SEVs) as they are used in TAVR on patients with BAV stenosis.</p> Methods <p>We searched the databases PubMed, Embase, Cochrane, and ScienceDirect from their inception until January 2025. An odds ratio (OR) and corresponding 95% confidence interval (CI) were determined for every outcome, with statistical significance at <i>p</i>-value &lt; 0.05. Random-effects models were used for studies with high heterogeneity (<i>I</i><sup>2</sup> &gt; 50%), and fixed-effects models for low heterogeneity (<i>I</i><sup>2</sup> ≤ 50%).</p> Results <p>Nine observational studies were included. There was no significant difference found for the following outcomes: procedural death, 30-day mortality, 1-year all-cause mortality, annulus rupture, acute kidney injury, stroke, and moderate/severe paravalvular leak between BEV and SEV.</p> <p>Still, having a BEV was associated with a lower risk of needing a pacemaker or requiring second valve surgery.</p> Conclusion <p>From this analysis, it seems that BEVs may provide better results than SEVs in terms of reducing the need for a pacemaker and a second valve in patients with BAV stenosis treated with TAVR. The number of deaths and serious complications was about the same for the two valves. Additional randomized controlled trials are needed to study both the lasting effects and the factors that shape these results.</p> Prospero ID <p>CRD420251003387</p>

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Balloon-expandable vs. self-expandable transcatheter aortic valve implantation in bicuspid aortic valve stenosis: a meta-analysis of observational studies

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Arun Kumar Maloth,
  • Tanish Baweja,
  • Aliyanoor Shaikh,
  • Sumin Thapa,
  • Soumyadeep Das,
  • Gurusha Jangid,
  • Rebecca Maria Varghese,
  • Muhammad Muneeb Khawar,
  • Wodwentzky Lefranc,
  • Olga Lopez,
  • Theresa Allagoa,
  • Sahithi Kantamaneni,
  • Parvathy Ajith,
  • Asraf Hussain,
  • Muneeb Khawar

摘要

Purpose

If patients with bicuspid aortic valve (BAV) stenosis are high-risk candidates for traditional open-heart surgery, they can be treated with transcatheter aortic valve replacement (TAVR). The purpose of this study is to understand the effects of balloon-expandable valves (BEVs) and self-expandable valves (SEVs) as they are used in TAVR on patients with BAV stenosis.

Methods

We searched the databases PubMed, Embase, Cochrane, and ScienceDirect from their inception until January 2025. An odds ratio (OR) and corresponding 95% confidence interval (CI) were determined for every outcome, with statistical significance at p-value < 0.05. Random-effects models were used for studies with high heterogeneity (I2 > 50%), and fixed-effects models for low heterogeneity (I2 ≤ 50%).

Results

Nine observational studies were included. There was no significant difference found for the following outcomes: procedural death, 30-day mortality, 1-year all-cause mortality, annulus rupture, acute kidney injury, stroke, and moderate/severe paravalvular leak between BEV and SEV.

Still, having a BEV was associated with a lower risk of needing a pacemaker or requiring second valve surgery.

Conclusion

From this analysis, it seems that BEVs may provide better results than SEVs in terms of reducing the need for a pacemaker and a second valve in patients with BAV stenosis treated with TAVR. The number of deaths and serious complications was about the same for the two valves. Additional randomized controlled trials are needed to study both the lasting effects and the factors that shape these results.

Prospero ID

CRD420251003387