Stroke Risk After Bioprosthetic Aortic Valve Replacement in Aortic Stenosis: Systematic Review and Meta-Analysis

作者：Tarek Bou Dargham, Sara Hassani, Brian Mac Grory, Melissa A. Daubert, Dylan Ryan, Tracy Truong, Mohammad Bahij Moumneh, Samantha Kaplan, Wuwei Feng, Nada El Husseini · 发表于：Stroke · 年份：2026 · DOI：10.1161/strokeaha.125.053422 · 被引用次数：1 · 研究领域：Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches、Infective Endocarditis Diagnosis and Management

BACKGROUND: Stroke is a possible complication after bioprosthetic aortic valve replacement (AVR) for severe aortic stenosis (AS), impacting morbidity and mortality. Accurate estimates of the proportion of individuals who experience stroke within and beyond the periprocedural period after transcatheter AVR (TAVR), surgical AVR, and valve-in-valve (ViV) replacement are essential for management and prognostication. The objective was to determine the proportion of adults aged >18 who experienced an ischemic stroke after bioprosthetic AVR for AS. METHODS: A systematic search of MEDLINE, Embase, and Web of Science was conducted from database inception through March 2024. Studies reporting on stroke rates at least 90 days after bioprosthetic AVR for severe AS, including ViV procedures, and meeting predefined eligibility criteria were included. The pooled proportion of individuals experiencing a stroke was estimated for TAVR and ViV procedures, whereas comparative analyses between TAVR and surgical AVR were performed using mixed-effects models in studies directly comparing both procedures. RESULTS: Twenty-seven studies were included in the native AS treatment cohort, and 5 in the ViV subanalysis. In native AS, the pooled 30-day proportion of individuals who had a stroke after TAVR was 3.0% (95% CI, 2.5-3.9), with different studies reporting major and minor stroke proportions of 1.7% each. At 1 year, all stroke proportion was 5.0% (95% CI, 4.0-6.0), major stroke was 3.0%, and minor st...