Khalifa et al. (2025) conducted a systematic review evaluating the use of transcatheter aortic valve replacement (TAVR) in patients with a quadricuspid aortic valve (QAV). The study identified 11 case reports/series (n = 17) and summarized procedural characteristics and short-term outcomes (1).
The study title and the methods section state that a random-effects meta-analysis was performed, “A random-effects model was used for meta-analysis,” to assess procedural success and 30-day mortality. However, a detailed examination of the reported statistical methods and results does not identify a quantitative synthesis consistent with a meta-analysis. The analyses are conducted at the individual-patient level using a one-stage descriptive approach, as mentioned in the methods section, “Individual participants’ data analysis was used. The analysis approach was a one-stage approach,” without study-level effect estimates, variance calculations, measures of heterogeneity (e.g., I2), or graphical meta-analytic outputs such as forest or funnel plots.
Although the authors state that a random-effects model was used, the described analytical approach does not reflect a random-effects meta-analysis as conventionally defined. In the absence of pooled estimates derived from multiple studies, the methodology more closely aligns with a descriptive systematic review of case reports rather than a meta-analysis.
Referring to the study as a “meta-analysis” may therefore overstate the level of quantitative evidence provided and could mislead readers regarding the strength and generalizability of the findings. Clarification of the analytical framework or a reconsideration of the terminology used in the title and methods would improve methodological transparency.
Statements
Author contributions
RR: Writing – original draft, Writing – review & editing.
Funding
The author(s) declared that financial support was not received for this work and/or its publication.
Conflict of interest
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References
1.
Khalifa MA Hashim HT Shimal AA Riyas Mohamed FR Ragunathan S Al Sakini AS et al Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis. Front Cardiovasc Med. (2025) 12:1572251. 10.3389/fcvm.2025.1572251
Summary
Keywords
aortic stenosis, QAV, quadricuspid aortic valves, systematic review, transcatheter aortic valve replacement
Citation
Ruzayqat RSH (2026) Commentary: Transcatheter aortic valve replacement in a quadricuspid aortic valve: a systematic review and meta-analysis. Front. Cardiovasc. Med. 12:1660716. doi: 10.3389/fcvm.2025.1660716
Received
06 July 2025
Revised
22 December 2025
Accepted
29 December 2025
Published
27 January 2026
Volume
12 - 2025
Edited by
Ernesto Greco, Sapienza University of Rome, Italy
Reviewed by
Bahar Darouei, Isfahan University of Medical Sciences, Iran
Updates
Copyright
© 2026 Ruzayqat.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rajeh S. H. Ruzayqat rajehruzayqat107@gmail.com
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.