SUMMARY

Introduction: Aortic stenosis (AS) is associated with high mortality after symptom onset. Indeed, mean survival after symptom onset is around 2-3 years, with a high probability of sudden death. Leading guidelines recommend that valve-replacement candidates should be severe symptomatic AS patients whose treatment of choice is conventional surgery. Even so, among patients with high surgical risk or in whom surgery is contraindicated, transcatheter aortic valve implantation (TAVI) would nonetheless appear to be an option meriting consideration.

Objectives: To analyse the safety, effectiveness and efficacy of percutaneous or transapical transcatheter implantation of bioprosthetic aortic valves in the treatment of severe symptomatic aortic stenosis.

Methods: A search of the scientific literature was made, covering the following databases: Centre for Reviews and Dissemination (CRD); Medline (PubMed); EMBASE (Ovid); ISI Web of Science (Web of Knowledge, WoK); Indice Médico Español (IME); Current Controlled Trials (CCT); International Standard Randomised Controlled Trial Number (ISRCTN); and ClinicalTrial.gov. This process was completed by a search of meta-search engines (Google Scholar) and websites of national and international organisations and assessment agencies. The strategy was implemented in July 2012 and monthly updates were conducted to retrieve recently published studies. Two reviewers, acting independently, selected the papers on the basis of pre-established inclusion/exclusion criteria. The data were then summarised in evidence tables and the methodological quality of the studies was separately assessed by two researchers using the scale issued by the Scottish Intercollegiate Guidelines Network.

Results, conclusions and recommendations: see pdf below