A meta-analysis of transfemoral versus transapical transcatheter aortic valve implantation on 30-day and 1-year outcomes

The Heart Surgery Forum
An ZhaoXu Zhiyun

Abstract

Transfemoral (TF) and transapical (TA) are two commonly used accesses in transcatheter aortic valve implantation (TAVI). Currently, the influence of TAVI access choice on 30-day and 1-year outcomes is unclear. The purpose of this study was to compare the 30-day and 1-year outcomes between TF-TAVI and TA-TAVI. Studies published from 2002 to September 2014 were collected by searching PubMed and Web of Knowledge. Studies were selected by two independent investigators. 30-day and 1-year outcomes were endpoints. Odds ratios (ORs) and hazard ratio (HR) with 95% confidence interval (CI) were computed. Fixed effect model was used if I2 < 50%; if I2 > 50%, random effect model was used. 14 studies met inclusion criteria and were included in our analysis (3837 patients in TF group, 1881 patients in TA group). Two were retrospective trials and the others were prospective trials. Our meta-analysis showed that compared with TA group, TF group had a lower 30-day mortality (7.5% versus 11.6%) and higher 1-year survival [HR 0.75, 95% CI (0.66, 0.86)], but the Logistic EuroSCORE was higher in TA group (P = 0.00). TF group had a significantly higher stroke rate of 4.0% compared with 2.2% in TA group at ≤30 days. The incidence of major vascu...Continue Reading

Citations

Aug 11, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Tesfaye TelilaLuis Afonso
Sep 6, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Sharan Prakash SharmaAshok Kondur
Jul 7, 2017·Nature Reviews. Cardiology·Brandon M JonesSamir R Kapadia
Jul 16, 2019·The Journal of Cardiovascular Surgery·Hisato TakagiUNKNOWN ALICE (All-Literature Investigation of Cardiovascular Evidence) Group
Dec 29, 2019·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Tamunoinemi Bob-ManuelUzoma N Ibebuogu

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