title: Meta-Analysis of the Effectiveness and Safety of Transcatheter Aortic Valve Implantation Without Balloon Predilation.
abstract: Evidence regarding the safety and feasibility of transcatheter aortic valve implantation without balloon predilation (BP) is scarce. A literature search of PubMed, EMBASE, CENTRAL, and major conference proceedings was performed from January 2002 to July 2015. There were 18 studies incorporating 2,443 patients included in the present study. No differences were observed in the baseline characteristics between patients without BP (no-BP) and with BP. Compared with BP, no-BP had a shorter procedure time (no-BP vs BP, 124.2 vs 138.8 minutes, p = 0.008), used less-contrast medium (no-BP vs BP, 126.3 vs 156.3 ml, p = 0.0005) and had a higher success rate (odds ratio [OR] 2.24, 95% CI 1.40 to -3.58). In addition, no-BP was associated with lower incidences of permanent pacemaker implantation (OR 0.45, 95% CI 0.3 to 0.67), grade 2 or greater paravalvular leakage (OR 0.55, 95% CI 0.37 to 0.83), and stroke (OR 0.57, 95% CI 0.32 to 1.0). Furthermore, no-BP was associated with a 0.6-fold decreased risk for 30-day all-cause mortality (OR 0.60, 95% CI 0.39 to 0.92). However, the difference in the risk for permanent pacemaker implantation, grade 2, or higher aortic regurgitation, stroke was noted to be significant only in the subgroup of the CoreValve-dominating studies. In conclusion, no-BP before transcatheter aortic valve implantation was not only safe and feasible but was also associated with fewer complications and short-term mortality in selected patients especially using self-expandable valve.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yan-Biao
authors.initials: YB
authors.lastname: Liao
authors.affiliation: Department of Urology Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Meng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Zhen-Gang
authors.initials: ZG
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Zuo
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yi-Jian
authors.initials: YJ
authors.lastname: Li
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Tian-Yuan
authors.initials: TY
authors.lastname: Xiong
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Cao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yuan-Ning
authors.initials: YN
authors.lastname: Xu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China. Electronic address: fynotebook@hotmail.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China. Electronic address: hmaochen@foxmail.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D063126:Balloon Valvuloplasty; D006350:Heart Valve Prosthesis; D006801:Humans; D011474:Prosthesis Design; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome