Comparison of 30-Day Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Replacement: A Single-Center US Experience

The Annals of Thoracic Surgery
Shishir MurarkaAshish Pershad

Abstract

The optimal access route for transcatheter aortic valve replacement (TAVR) remains debatable. We compared early safety outcomes at 30 days between the transfemoral (TF) and transapical (TA) approaches in a single, high-volume center in the United States. Data were collected retrospectively on consecutive patients who underwent TAVR by the TF or TA approach. The primary endpoints included the following: all-cause mortality; stroke; major and life threatening bleeding; renal failure; valve-related dysfunction requiring an intervention; and moderate to severe paravalvular leak and major vascular complications at 30 days. The secondary endpoints included need for a pacemaker and hospital length of stay. A total of 123 well-matched patients underwent TAVR (TF 66 [54%] and TA 57 [46%]). All-cause mortality at 30 days was identical in both groups (TF 4.5% vs TA 5.3%, p = 0.999). The rates of myocardial infarction (TF 1.6% vs TA 1.5%, p = 0.999) and stroke (TF 3.0% vs TA 5.3%, p = 0.662) were similar. Major bleeding, acute renal failure, valve-related dysfunction, paravalvular leak, and mean hospital length of stay were also similar in both groups. Unplanned vascular complications, fluoroscopy time, and contrast utilization were signif...Continue Reading

References

Dec 23, 2008·The Annals of Thoracic Surgery·Thomas WaltherMichael Mack
Mar 23, 2011·The Annals of Thoracic Surgery·See Hooi EweJeroen J Bax
Mar 27, 2012·The New England Journal of Medicine·Raj R MakkarUNKNOWN PARTNER Trial Investigators
Aug 7, 2012·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Carsten J BellerKlaus Kallenbach
Jan 1, 2014·Journal of Interventional Cardiology·Daniel J BlackmanUNKNOWN National Institute for Cardiovascular Outcomes Research (NICOR)
May 13, 2014·Journal of the American College of Cardiology·Adam B GreenbaumRobert J Lederman

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Citations

Feb 24, 2016·The Journal of Thoracic and Cardiovascular Surgery·Augusto D'OnofrioUNKNOWN Italian Transcatheter Balloon-Expandable Registry and the Sutureless Aortic Valve Implantation Research Groups
May 9, 2015·The Annals of Thoracic Surgery·Brett C Sheridan
Aug 2, 2016·JACC. Cardiovascular Interventions·Adrian Attinger-TollerFabian Nietlispach
Sep 7, 2017·Journal of Cardiothoracic Surgery·Enrico FerrariLudwig Karl von Segesser

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