Transcatheter Aortic Valve Replacement in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis

Authors

Ashraf Ahmed, Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.
Rasha Kaddoura, Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Abhinav Aggarwal, Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.
Tawanda Zinyandu, Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.
Fabricio Webber, Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.
Carlos Davila, Division of Cardiovascular Diseases, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.
Stuart Zarich, Division of Cardiovascular Diseases, Bridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut, USA.

Document Type

Article

Publication Title

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

Abstract

BACKGROUND: The co-existence of severe aortic stenosis (AS) and hypertrophic cardiomyopathy (HCM) is not uncommon. Surgical intervention is the gold standard management. Patients with high surgical risk might undergo transcatheter aortic valve replacement (TAVR). However, TAVR outcomes are unclear in this population. We aimed to investigate the impact of HCM on the outcomes of TAVR. AIM: We aim to investigate the outcomes of TAVR in patients with HCM. METHODS: We systematically searched PubMed, EMBASE, and Scopus for studies that compared outcomes of TAVR procedure between patients with HCM and those without it. Using the random-effects model, the odds ratios (OR) with 95% confidence interval (CI) were reported. RESULTS: We screened 102 articles and identified three observational cohort studies. Compared to patients who underwent TAVR without underlying HCM, TAVR for AS co-existed with HCM was associated with higher rates of mortality (OR 5.79; 95% CI: 3.38; 9.91, p < 0.0001), cardiogenic shock (OR 4.55; 95% CI: 3.40; 6.08, p < 0.0001), aortic dissection (OR 4.95; 95% CI: 3.17; 7.74, p < 0.0001), vascular complications (OR 2.10; 95% CI: 1.27; 3.47, p = 0.004), and renal impairment (OR 1.80; 95% CI: 1.36; 2.40, p < 0.0001). There was no difference between the comparison groups in terms of complete heart block, new permanent pacemaker implantation, or bleeding. CONCLUSION: In patients with severe AS and HCM, TAVR was associated with significantly higher occurrence of mortality, cardiogenic shock, aortic dissection, vascular complications, and renal impairment as well as the need for mechanical ventilation than patients who did not have HCM.

DOI

10.1002/ccd.31367

Publication Date

1-2-2025

Recommended Citation

Ahmed, Ashraf; Kaddoura, Rasha; Aggarwal, Abhinav; Zinyandu, Tawanda; Webber, Fabricio; Davila, Carlos; and Zarich, Stuart, "Transcatheter Aortic Valve Replacement in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis" (2025). Cardiology. 110.
https://scholar.bridgeporthospital.org/cardiology/110

Identifier

39748537 (pubmed); 10.1002/ccd.31367 (doi)