A systematic review of patient baseline characteristics, procedural details and outcomes of combined transcatheter valvular interventions.
Abstract Background Valvular heart pathologies remain amongst the most encountered conditions surgeons and interventionists face today. Multi-valve procedures exhibit higher operative mortality than do single valve procedures, with a mortality rate that is double its counterpart. Up until recently, surgical repair was the gold standard for most diseased valves. With the advent of new percutaneous and transcatheter technologies for valve replacement, many patients deemed inoperable due to prohibitively high surgical risk have been able to benefit from these new lesser invasive techniques. Currently, one systematic review article exists by Ando et al which included 37 studies and 60 patients and demonstrated reasonable clinical outcomes in patients undergoing combined transcatheter aortic and mitral valve intervention (CTAMVI). Since that original article, many new papers and studies have been published. We purpose an updated systematic review of all cases of combined percutaneous/transcatheter multi-valvular repairs.Methods An electronic search will be performed in PubMed, EMBASE, and Cochrane through September 2020 to identify eligible observation studies and RCTs. A complete electronic search will be conducted from January 1st 2000 to September 1st 2020 with Pubmed, EMBASE and Cochrane. All search results will be uploaded to COVIDENCE and screened by title or abstract and included for full manuscript review when it’s deemed relevant to the systematic review. All data will be abstracted into a dedicated excel spreadsheet and used for further data analysis. Demographic information such as patient’s age, sex and location will be extracted. Further information such as performed procedure, surgical risk, whether procedures were done simultaneously or staged, deployed device and clinical outcomes will be extracted as well. Discussion Within the medical literature, there is limited data available regarding combined transcatheter aortic, mitral, and tricuspid valve intervention. This is an attractive alternative in high-surgical risk patients with combined valvular disease. However, its procedural details and clinical outcomes have not been well described in any current medical guidelines. Through our systematic review we will be able to better elucidate and a establish strategies for undergoing transcatheter interventions in high risk patients who require multi-valvular repair.
