The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes

The impact of ascending aorta dilatation (AAD) on transcatheter aortic valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear. This meta-analysis aims to compare the outcomes of TAVI between patients with and without AAD. We systematically searched PubMed, ScienceDirect, Web of Sci...

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Main Authors: Pandit Bagus Tri Saputra, Wynne Widiarti, Ali Mustofa, Cornelia Ghea Savitri, Johanes Nugroho Eko Putranto, Faisal Yusuf Ashari, Chaq El Chaq Zamzam Multazam, Firas Farisi Alkaff, Mario D’Oria
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Cardiology: Heart & Vasculature
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352906725000831
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author Pandit Bagus Tri Saputra
Wynne Widiarti
Ali Mustofa
Cornelia Ghea Savitri
Johanes Nugroho Eko Putranto
Faisal Yusuf Ashari
Chaq El Chaq Zamzam Multazam
Firas Farisi Alkaff
Mario D’Oria
author_facet Pandit Bagus Tri Saputra
Wynne Widiarti
Ali Mustofa
Cornelia Ghea Savitri
Johanes Nugroho Eko Putranto
Faisal Yusuf Ashari
Chaq El Chaq Zamzam Multazam
Firas Farisi Alkaff
Mario D’Oria
author_sort Pandit Bagus Tri Saputra
collection DOAJ
description The impact of ascending aorta dilatation (AAD) on transcatheter aortic valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear. This meta-analysis aims to compare the outcomes of TAVI between patients with and without AAD. We systematically searched PubMed, ScienceDirect, Web of Science, Springer, Cochrane, and Clinicaltrials.gov. for articles up to 25 March 2024 (PROSPERO ID CRD42024526311). A total of 204,078 patients from ten studies were included. Paravalvular regurgitation (RR 1.56 95 %CI: 1.32–1.84, p < 0.00001, I2 = 0 %) and aortic dissection (RR 3.55 95 %CI: 1.79–7.06, p = 0.0003, I2 = 40 %) were more common in AAD group. However, there were no differences in peri-procedural (RR 1.09, 95 %CI: 0.83–1.42, p = 0.53, I2 = 0 %) and 1-year (RR 0.79, 95 %CI: 0.51–1.23, p = 0.30, I2 = 0 %) mortality. Three-years (RR 0.88, 95 %CI: 0.54–1.44, p = 0.62) and five-years (RR 0.85, 95 %CI: 0.45–1.6, p = 0.61) follow-up showed comparable mortality between both groups. The other complications and the need for second valve implantation (RR 1.24, 95 %CI: 0.70–20.20, p = 0.48, I2 = 65 %) were similar between both groups. Despite the higher incidence of aortic dissection and paravalvular regurgitation in AAD than in non-AAD patients, these complications were not associated with worse short-term or long-term mortality. Therefore, TAVI remains a safe and effective option for AAD patients.
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spelling doaj-art-e9de3b4d884f42e99a7808118eb745142025-08-20T03:09:45ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-06-015810168010.1016/j.ijcha.2025.101680The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomesPandit Bagus Tri Saputra0Wynne Widiarti1Ali Mustofa2Cornelia Ghea Savitri3Johanes Nugroho Eko Putranto4Faisal Yusuf Ashari5Chaq El Chaq Zamzam Multazam6Firas Farisi Alkaff7Mario D’Oria8Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, Indonesia; Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Jl. Prof. DR. Moestopo No.6-8, Airlangga, Kec. Gubeng, Surabaya, East Java 60286, IndonesiaFaculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, IndonesiaFaculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, Indonesia; Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Jl. Prof. DR. Moestopo No.6-8, Airlangga, Kec. Gubeng, Surabaya, East Java 60286, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, Indonesia; Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Jl. Prof. DR. Moestopo No.6-8, Airlangga, Kec. Gubeng, Surabaya, East Java 60286, IndonesiaFaculty of Biology Medicine and Health Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UKNational Heart and Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, London SW3 6LY, UKDepartment of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, The Netherlands; Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Jl. Prof. DR. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, East Java 60132, Indonesia; Corresponding author at: Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, The Netherlands.Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, Strada di Fiume, 447 34149 Cattinara, Trieste, ItalyThe impact of ascending aorta dilatation (AAD) on transcatheter aortic valve implantation (TAVI) outcomes, compared to non-AAD, remains unclear. This meta-analysis aims to compare the outcomes of TAVI between patients with and without AAD. We systematically searched PubMed, ScienceDirect, Web of Science, Springer, Cochrane, and Clinicaltrials.gov. for articles up to 25 March 2024 (PROSPERO ID CRD42024526311). A total of 204,078 patients from ten studies were included. Paravalvular regurgitation (RR 1.56 95 %CI: 1.32–1.84, p < 0.00001, I2 = 0 %) and aortic dissection (RR 3.55 95 %CI: 1.79–7.06, p = 0.0003, I2 = 40 %) were more common in AAD group. However, there were no differences in peri-procedural (RR 1.09, 95 %CI: 0.83–1.42, p = 0.53, I2 = 0 %) and 1-year (RR 0.79, 95 %CI: 0.51–1.23, p = 0.30, I2 = 0 %) mortality. Three-years (RR 0.88, 95 %CI: 0.54–1.44, p = 0.62) and five-years (RR 0.85, 95 %CI: 0.45–1.6, p = 0.61) follow-up showed comparable mortality between both groups. The other complications and the need for second valve implantation (RR 1.24, 95 %CI: 0.70–20.20, p = 0.48, I2 = 65 %) were similar between both groups. Despite the higher incidence of aortic dissection and paravalvular regurgitation in AAD than in non-AAD patients, these complications were not associated with worse short-term or long-term mortality. Therefore, TAVI remains a safe and effective option for AAD patients.http://www.sciencedirect.com/science/article/pii/S2352906725000831Ascending aortic dilatationComplicationMortalitySafetyTranscatheter aortic valve implantationCardiovascular disease
spellingShingle Pandit Bagus Tri Saputra
Wynne Widiarti
Ali Mustofa
Cornelia Ghea Savitri
Johanes Nugroho Eko Putranto
Faisal Yusuf Ashari
Chaq El Chaq Zamzam Multazam
Firas Farisi Alkaff
Mario D’Oria
The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
International Journal of Cardiology: Heart & Vasculature
Ascending aortic dilatation
Complication
Mortality
Safety
Transcatheter aortic valve implantation
Cardiovascular disease
title The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
title_full The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
title_fullStr The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
title_full_unstemmed The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
title_short The impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
title_sort impact of ascending aorta dilatation on transcatheter aortic valve implantation outcomes
topic Ascending aortic dilatation
Complication
Mortality
Safety
Transcatheter aortic valve implantation
Cardiovascular disease
url http://www.sciencedirect.com/science/article/pii/S2352906725000831
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