Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis
BackgroundWhile Transcatheter Aortic Valve Replacement (TAVR) is now a standard treatment for severe aortic stenosis, its use in patients with quadricuspid aortic valves (QAV) presents unique challenges. This review analyzes current evidence to guide clinicians in managing aortic stenosis in this co...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572251/full |
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| author | Mostafa A. Khalifa Hashim Talib Hashim Aya Ahmed Shimal Fathima Raahima Riyas Mohamed Srinithi Ragunathan Ahmed Sermed Al Sakini Mohamed H. Elbadawi Mohammed Rushdhi Irfan Ibrahim Moqbel Marwah Mohammed Almualed Mohammedbaqer Al-Ghuraibawi Batool S. Al-Aboudi |
| author_facet | Mostafa A. Khalifa Hashim Talib Hashim Aya Ahmed Shimal Fathima Raahima Riyas Mohamed Srinithi Ragunathan Ahmed Sermed Al Sakini Mohamed H. Elbadawi Mohammed Rushdhi Irfan Ibrahim Moqbel Marwah Mohammed Almualed Mohammedbaqer Al-Ghuraibawi Batool S. Al-Aboudi |
| author_sort | Mostafa A. Khalifa |
| collection | DOAJ |
| description | BackgroundWhile Transcatheter Aortic Valve Replacement (TAVR) is now a standard treatment for severe aortic stenosis, its use in patients with quadricuspid aortic valves (QAV) presents unique challenges. This review analyzes current evidence to guide clinicians in managing aortic stenosis in this complex valve morphology.MethodFollowing PRISMA guidelines, a comprehensive literature search was conducted across multiple databases up to August 15, 2024. A random-effects model was used for meta-analysis, focusing on 30-day mortality and procedural success, with secondary outcomes including paravalvular leak incidence, pacemaker insertion, hemodynamic changes, and NYHA functional class improvement.ResultsA total of 11 case reports/series were analyzed, involving 17 adult patients with QAV. Participants had a mean age of 73.80 ± 5.07 years. The mean left ventricular ejection fraction was 41.6%, and the mean annulus area was 595.5 mm2. Most patients (64.7%) underwent transfemoral procedures, with nearly 70% receiving a J-valve or Edwards SAPIEN 3 device. All procedures were largely successful, though 29.4% experienced leakage or regurgitation. Aortic pre-dilation was done in 41.2% of cases. The mean procedural duration was 102 min, with a fluoroscopic duration of 15 min. No patients experienced aortic post-dilation, and one (5.8%) had an atrioventricular block within 30 days post-procedure.ConclusionTAVR is an effective and growing treatment for high-risk patients with aortic valve disease, including those with QAV. While it has high success rates and challenges (i.e., post-operatively). Future studies should focus on long-term valve durability. |
| format | Article |
| id | doaj-art-6ba0f27d0e474f64b8562391776fe4c0 |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-6ba0f27d0e474f64b8562391776fe4c02025-08-20T03:20:11ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15722511572251Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysisMostafa A. Khalifa0Hashim Talib Hashim1Aya Ahmed Shimal2Fathima Raahima Riyas Mohamed3Srinithi Ragunathan4Ahmed Sermed Al Sakini5Mohamed H. Elbadawi6Mohammed Rushdhi Irfan7Ibrahim Moqbel8Marwah Mohammed Almualed9Mohammedbaqer Al-Ghuraibawi10Batool S. Al-Aboudi11Faculty of Medicine, Cairo University, Cairo, EgyptCollege of Medicine, University of Warith Al-Anbiyaa, Karbala, IraqCollege of Medicine, University of Baghdad, Baghdad, IraqCollege of Medicine, Alfaisal University, Riyadh, Saudi ArabiaPanimalar Medical College and Research Institute, Chennai, IndiaCollege of Medicine, University of Baghdad, Baghdad, IraqFaculty of Medicine, University of Khartoum, Khartoum, SudanCollege of Medicine, Alfaisal University, Riyadh, Saudi ArabiaFaculty of Medicine, Cairo University, Cairo, EgyptCollege of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCollege of Medicine, University of Warith Al-Anbiyaa, Karbala, IraqFaculty of Medicine, University of Kufa, Najaf, IraqBackgroundWhile Transcatheter Aortic Valve Replacement (TAVR) is now a standard treatment for severe aortic stenosis, its use in patients with quadricuspid aortic valves (QAV) presents unique challenges. This review analyzes current evidence to guide clinicians in managing aortic stenosis in this complex valve morphology.MethodFollowing PRISMA guidelines, a comprehensive literature search was conducted across multiple databases up to August 15, 2024. A random-effects model was used for meta-analysis, focusing on 30-day mortality and procedural success, with secondary outcomes including paravalvular leak incidence, pacemaker insertion, hemodynamic changes, and NYHA functional class improvement.ResultsA total of 11 case reports/series were analyzed, involving 17 adult patients with QAV. Participants had a mean age of 73.80 ± 5.07 years. The mean left ventricular ejection fraction was 41.6%, and the mean annulus area was 595.5 mm2. Most patients (64.7%) underwent transfemoral procedures, with nearly 70% receiving a J-valve or Edwards SAPIEN 3 device. All procedures were largely successful, though 29.4% experienced leakage or regurgitation. Aortic pre-dilation was done in 41.2% of cases. The mean procedural duration was 102 min, with a fluoroscopic duration of 15 min. No patients experienced aortic post-dilation, and one (5.8%) had an atrioventricular block within 30 days post-procedure.ConclusionTAVR is an effective and growing treatment for high-risk patients with aortic valve disease, including those with QAV. While it has high success rates and challenges (i.e., post-operatively). Future studies should focus on long-term valve durability.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572251/fulltranscatheter aortic valve replacementquadricuspid aortic valvesaortic stenosisprocedural successQVA |
| spellingShingle | Mostafa A. Khalifa Hashim Talib Hashim Aya Ahmed Shimal Fathima Raahima Riyas Mohamed Srinithi Ragunathan Ahmed Sermed Al Sakini Mohamed H. Elbadawi Mohammed Rushdhi Irfan Ibrahim Moqbel Marwah Mohammed Almualed Mohammedbaqer Al-Ghuraibawi Batool S. Al-Aboudi Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis Frontiers in Cardiovascular Medicine transcatheter aortic valve replacement quadricuspid aortic valves aortic stenosis procedural success QVA |
| title | Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis |
| title_full | Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis |
| title_fullStr | Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis |
| title_full_unstemmed | Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis |
| title_short | Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis |
| title_sort | transcatheter aortic valve replacement in quadricuspid aortic valve a systematic review and meta analysis |
| topic | transcatheter aortic valve replacement quadricuspid aortic valves aortic stenosis procedural success QVA |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1572251/full |
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