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Lam et al. Vessel Plus 2019;3:27 I http://dx.doi.org/10.20517/2574-1209.2019.009 Page 5 of 9

Figure 1. Forest plot for relative risk ratios of any PVL for TTE-TAVI in comparison to TEE-TAVI with subgroups based on study type. TTE;
transthoracic echocardiography; TEE: transesophageal echocardiography; RR: relative risk; CI: confidence interval; PVL: paravalvular leak;
TAVI: transcatheter aortic valve implantation

Table 2. Pooled event means and weighted differences for continuous events from meta-analysis
TTE mean TEE mean MD (95%CI) P value
Length of stay (days)
Observational adjusted 6.3 7.2 -0.91 (-2.27 to 0.44) 0.19
Observational unadjusted 5.3 7.2 -1.89 (-2.6 to -1.17) < 0.01
Pooled 5.6 7.2 -1.55 (-2.27 to -0.83) < 0.01
ICU time (h)
Observational adjusted 59.7 54.2 6.22 (-16.34 to 28.78) 0.59
Observational unadjusted 39.6 59.5 -12.68 (-22.28 to -3.09) < 0.01
Pooled 47.4 49.9 -5.6 (-13.66 to 2.45) 0.17
Fluoroscopic time (min)
Observational adjusted 20.9 21.7 -0.71 (3.91 to 2.5) 0.67
Observational unadjusted 21.0 22.8 -1.79 (-3.36 to -0.22) 0.03
Pooled 21.0 22.3 -1.34 (-2.84 to 0.16) 0.08
Contrast volume (mL)
Observational adjusted 126.7 161.7 -35.0 (-56.89 to -13.11) < 0.01
Observational unadjusted 96.2 119.0 -22.83 (-51.14 to 5.48) 0.11
Pooled 101.2 126.0 -24.75 (-49.48 to -0.03) 0.05
Procedure time (min)
Observational adjusted 98.6 118.1 -44.29 (-90.96 to 2.38) < 0.06
Observational unadjusted 123.1 142.6 -19.44 (-33.01 to -5.87) < 0.01
Pooled 110.5 130 -31.09 (-54.77 to -7.40) 0.01

TTE: transthoracic echocardiography; TEE: transesophageal echocardiography; MD: mean difference; CI: confidence interval

which was significant (MD: -35.00 mL, 95%CI: -56.89 to -13.11, P ≤ 0.01), and not significant in the
unmatched observational subgroup (MD: -22.83 mL, 95%CI: -51.14 to 5.48, P = 0.11).

The procedure time was significantly shorter in the TTE group compared to the TEE group (MD: -31.09 min,
95%CI: -54.77 to -7.40, P ≤ 0.01). The subgroups also showed similar patterns.