TRANSCATHETER AORTIC VALVE REPLACEMENT IN SOUTH-AMERICA- A META-ANALYSIS OF REAL-LIFE OUTCOMES

Author(s)

Boissonnet CP1, Giorgi M1, Thierer J1, Guetta JN1, Giglio N2, Micone P1, Gonzalez CD1
1Intituto universitario CEMIC, buenos Aires, Argentina, 2Hospital de Ninos Ricardo Gutierrez Ciudad de Buenos Aires Argentina, Buenos Aires, Argentina

OBJECTIVES: TAVR consists in the replacement of a dysfunctional aortic valve (mostly due to severe aortic stenosis) using a percutaneously implanted device. Its use is worldwide accepted as an alternative to surgical valve replacement and it has been available in South America since 2008. In order to know the clinical outcomes of this technology in a real-life setting we conducted this meta-analysis of data from this region METHODS: a systematic literature search of both abstracts (presented in regional and national scientific sessions) and published papers reporting clinical outcomes since 2008 to 2015 were conducted. We identify cohorts from South America that fulfill the inclusion criteria. The primary endpoint was procedure success defined by the Valve Academic Research Consortium (VARC2) criteria. All outcomes were assessed during hospitalization and at 30 days. We tested for between-study heterogeneity using Cochrane’s Q and I statistic; given that most analysis yield high heterogeneity (p <0.05 or I>50%) we used a random-effects model to calculate the pooled estimates RESULTS: Twenty seven cohorts comprising 1156 patients were included in the meta-analysis. Regarding the devices implanted, 12 studies used only CoreValve, 1 study only Inovare and 1 study only SAPIEN. Procedure success was 86.9% (95CI 81.8% -90.8%; ICONCLUSIONS: this study provides a real life benchmark for the performance of this technology in the region. In general terms, clinical results are similar to those reported in the literature. We observed a great heterogeneity possibly due to the disparity of populations included, learning curve and reporting biases.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PMD11

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Cardiovascular Disorders

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