{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:16:41Z","timestamp":1792192601784,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis. However, the need for unplanned conversion to cardiac surgery (CS) during TAVI remains an infrequent but critical event. It is unclear whether this risk is higher in patients undergoing urgent procedures. We conducted a systematic review and meta\u2010analysis to compare the incidence of unplanned conversion to CS between patients undergoing urgent versus elective TAVI. A systematic search of PubMed, SCOPUS, and Cochrane databases was performed to identify eligible studies. The primary outcome was the rate of unplanned conversion to CS. Secondary outcomes included mortality, device success, vascular complications, device embolization, acute kidney injury (AKI), stroke, permanent pacemaker implantation (PPI), moderate\u2010or\u2010severe paravalvular regurgitation (PVL), need for second valve implantation, bleeding, and duration of hospitalization. Seven studies comprising 71,909 patients were analyzed; 5108 underwent urgent TAVI and 66,801 underwent elective TAVI. No significant difference in conversion to CS was observed between the groups (RR: 0.89; 95% CI: 0.65\u22121.22). Device success rates were similar (RR: 0.99; 95% CI: 0.97\u20131.00). Urgent TAVI was associated with prolonged hospitalization (mean difference: 7.75 days; 95% CI: 4.06\u201311.45) and increased AKI risk (RR: 2.20; 95% CI: 1.53\u20133.16). Vascular complications, device embolization, stroke, PPI, PVL, second valve implantation, and major bleeding rates were comparable between the groups. Urgent TAVI is not associated with an increased risk of unplanned conversion to surgery. The observed higher AKI rates and longer hospital stay suggest that patient\u2010related factors beyond procedural urgency may contribute to adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70309","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T04:14:17Z","timestamp":1762834457000},"page":"210-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Conversion to Cardiac Surgery During Elective and Urgent Transcatheter Aortic Valve Implantation: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-7015","authenticated-orcid":false,"given":"Nikolaos","family":"Ktenopoulos","sequence":"first","affiliation":[{"name":"First Department of Cardiology, Hippokration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"},{"name":"Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2616-7952","authenticated-orcid":false,"given":"Anastasios","family":"Apostolos","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Hippokration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"},{"name":"Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios\u2010David","family":"Chlorogiannis","sequence":"additional","affiliation":[{"name":"Department of Radiology Brigham and Women's Hospital Boston Massachusetts 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National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Drakopoulou","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Hippokration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"},{"name":"Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Synetos","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Hippokration General Hospital of Athens National and Kapodistrian University of Athens Athens Greece"},{"name":"Unit of Structural Heart Diseases, First Department of Cardiology, Medical School, Hippocration General Hospital of Athens National and Kapodistrian University of Athens Athens 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