Effect of Transcatheter Aortic Valve Replacement on Right Ventricular Systolic Function: Systematic Review and Meta-analyses

Abstract

Objectives: We ought to compare the effect of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) on right ventricular systolic function (RVSF) in high risk patients with severe aortic stenosis (AS). Methodology: Data source: PubMed, EMBASE, Cochrane library, and references of selected articles. Study Endpoints: Transthoracic echocardiography was utilized to assess the change in RVSF post TAVR versus SAVR using tricuspid annular plane systolic excursion (TAPSE), and fractional area change (RVFAC). Statistical analyses: Random effect model on standardized mean difference (Hedges; g) were used together with heterogeneity assessment. Result: We included 485 patients from five single-center observational studies. TAVR had no effect while SAVR had negative effect on RVSF, and the effect was in favor of TAVR when TAVR compared to SAVR [TAPSE (g=2.88, SE=0.63, P<0.001, Q=73.18, I2=94.53, r=0.65), and RVFAC (g=0.91, SE=0.16, P<0.001, Q=2.39, I2=16.61), r=0.65]. Conclusion: Compared with SAVR, TAVR is preferred aortic intervention for patients with severe symptomatic AS and RV systolic dysfunction.