Efectividad y complicaciones del implante de válvula aórtica transcatéter. Revisión sistemática

Abstract

Title: Effectiveness and Complications of Transcatheter Aortic Valve Implantation: A Systematic Review. Objective: To analyze the effectiveness and complications associated with Transcatheter Aortic Valve Implantation (TAVI) in patients with severe aortic stenosis. Methodology: Following PRISMA guidelines, studies were included comparing patients with aortic stenosis who underwent TAVI within the last 10 years. The search was conducted on PubMed, Elsevier, Springer Link, and SciELO databases. The Cochrane RoB 2.0 tool was used to evaluate the risk of bias, and the GRADE approach was applied to estimate the quality of evidence. Results: Twenty-five 25 articles representing 37,825 patients were considered. The findings indicated that TAVI demonstrated significant effectiveness comparable to Surgical Aortic Valve Replacement (SAVR) regarding short- and long-term mortality. However, TAVI was associated with a higher risk of vascular complications and an increased need for permanent pacemakers. Conversely, TAVI revealed lower rates of stroke and respiratory complications, highlighting its favorable safety profile compared to SAVR. Discussion: The evidence's limitations include risks of bias in observational studies and heterogeneity among the studied populations. Further research is required to corroborate these findings and provide more specific clinical recommendations. Conclusions and Relevance: TAVI is a viable alternative to SAVR, with favorable outcomes in effectiveness and safety, albeit with certain complications. Keywords: aortic stenosis, transcatheter valve replacement