Effect of Pulmonary Hypertension on Survival Outcomes in Patients With Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Sulafa Khalil, Godfrey Tabowei, Mandeep Kaur, Samuel K. Dadzie, Sajog Kansakar, Merid Moqattash, Praveen Kumar Komminni, Sujith K. Palleti
Hamad Medical Corporation. Texas Tech University Health Sciences Center. HCA Capital Hospital. Piedmont Athens Regional Medical Center. Maimonides Medical Center. University of Pécs Medical School. Suraksha Hospital. Louisiana State University Health Sciences Center.
Qatar, United States, Hungary and India

Cureus
Cureus 2024;
DOI: 10.7759/cureus.58540

Abstract
The aim of this meta-analysis was to determine the effect of pulmonary hypertension (PH) on survival in patients undergoing transcatheter aortic valve replacement (TAVR). The present study was conducted according to the guidelines of Preferred Reporting of Systematic Review and Meta-Analysis (PRISMA). We conducted a comprehensive search of electronic databases including PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science from January 1, 2015, to March 10, 2024. Outcomes assessed in this meta-analysis included early and late all-cause mortality and cardiovascular mortality. Total 15 studies were integrated into the pooled analysis to assess the impact of PH on outcomes among patients undergoing TAVR, comprising a total sample size of 35,732 individuals. The pooled prevalence of PH stood at 52.57% (n=18,767). Predominantly, the studies were conducted in the United States (n=6), followed by Germany (n=3), with one study each from Japan, Italy, Switzerland, Brazil, Poland, and Australia. Pooled analysis showed that risk of short-term mortality was greater in patients with PH compared to patients without PH (risk ratio (RR): 1.46, 95% CI: 1.19 to 1.80). Risk of long-term mortality was greater in patients with PH (RR: 1.42, 95% CI: 1.29 to 1.55). Risk of cardiovascular mortality was also greater in patients with PH compared to patients without PH (RR: 1.66, 95% CI: 1.36 to 2.02). We advocate for further research to address gaps in understanding different types of PH and their impacts on mortality and cardiovascular outcomes.

Category
Class II. Pulmonary Hypertension Associated with Valvular Disease of the Left Side of the Heart
Procedural Risk and Care for Individuals with Pulmonary Vascular Disease

Age Focus: Adult Pulmonary Vascular Disease

Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication

Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes

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