title: Causes of Death Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Transcatheter aortic valve replacement (TAVR) is an effective alternative to surgical aortic valve replacement in patients at high surgical risk. However, there is little published literature on the exact causes of death.
  
  
  RESULTS
  The PubMed database was systematically searched for studies reporting causes of death within and after 30 days following TAVR. Twenty-eight studies out of 3934 results retrieved were identified. In the overall analysis, 46.4% and 51.6% of deaths were related to noncardiovascular causes within and after the first 30 days, respectively. Within 30 days of TAVR, infection/sepsis (18.5%), heart failure (14.7%), and multiorgan failure (13.2%) were the top 3 causes of death. Beyond 30 days, infection/sepsis (14.3%), heart failure (14.1%), and sudden death (10.8%) were the most common causes. All possible subgroup analyses were made. No significant differences were seen for proportions of cardiovascular deaths except the comparison between moderate (mean STS score 4 to 8) and high (mean STS score >8) -risk patients after 30 days post-TAVR (56.0% versus 33.5%, P=0.005).
  
  
  CONCLUSIONS
  Cardiovascular and noncardiovascular causes of death are evenly balanced both in the perioperative period and at long-term follow-up after TAVR. Infection/sepsis and heart failure were the most frequent noncardiovascular and cardiovascular causes of death. This study highlights important areas of clinical focus that could further improve outcomes after TAVR.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Tian-Yuan
authors.initials: TY
authors.lastname: Xiong
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Yan-Biao
authors.initials: YB
authors.lastname: Liao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Zhen-Gang
authors.initials: ZG
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Yuan-Ning
authors.initials: YN
authors.lastname: Xu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Xin
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Zuo
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Yi-Jian
authors.initials: YJ
authors.lastname: Li
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Cao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.affiliation: Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (H.J.).
authors.forename: Hasan
authors.initials: H
authors.lastname: Jilaihawi
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Yuan
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (T.Y.X., Y.B.L., Z.G.Z., Y.N.X., X.W., Z.L.Z., Y.J.L., J.Y.C., H.T., Y.F., M.C.).
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D003645:Death, Sudden / Q000209:etiology; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality*; D006801:Humans; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome
keywords: aortic stenosis; death; transcatheter valve replacement