Key result
TA-TAVR shows ~22% overall survival at 8 years in severe AS.
Why the study?
Transapical-transcatheter aortic valve replacement is used when peripheral access is challenging, but reports on its long-term outcomes have been lacking.
Does transapical-transcatheter aortic valve replacement provide satisfactory long-term outcomes in patients with native aortic stenosis?
Observational (n=173)
No
Does transapical-transcatheter aortic valve replacement provide satisfactory long-term outcomes in patients with native aortic stenosis?
Transapical-transcatheter aortic valve replacement provides satisfactory long-term outcomes up to 8 years, suggesting it remains a viable alternative for patients with challenging peripheral access.
Answers are grounded in this paper and cite their sources.
May support transapical TAVR in difficult-access patients; leaves open randomized confirmation of long-term outcomes.
OBJECTIVE: Transapical-transcatheter aortic valve replacement is one of the main interventions indicated for patients where access via peripheral vessels is challenging. However, there have been no reports on the long-term outcomes of this intervention. Here, we report the long-term outcomes of this intervention. METHODS: Among 178 patients who underwent transapical-transcatheter aortic valve replacement between October 2009 and July 2023, 173 patients who underwent this intervention for native aortic stenosis were included in this study, and early and long-term results were evaluated. In-hospital mortality was observed in three patients (1.7%). Mean follow-up duration was 4.3 ± 2.8 years, and the survival rates at 1-, 3-, 5-, and 8-years were 84.9%, 67.1%, 47.0%, and 22.1%, respectively. Freedom from cardiovascular mortality at 1, 3, 5, and 8-years was 92.9%, 86.1%, 75.8%, and 53.5%, respectively. The freedom from disabling stroke rates at 1, 3, 5, and 8-years were 95.0%, 92.4%, 92.4%, and 90.8%, respectively. Multivariate analysis revealed that male (Hazard Ratio 1.85, 95%Confidence Interval 1.27-2.70, p = 0.0012) and hemodialysis (Hazard Ratio 1.64, 95%Confidence Interval 1.00-2.67, p = 0.049) were significant poor prognosis factors. CONCLUSIONS: Long-term outcomes of transapical-transcatheter aortic valve replacement were satisfactory. Despite the variety of available approaches, the role of transapical-transcatheter aortic valve replacement, which has low vascular impact, has not been completely lost.
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Maeda et al. (2024) conducted an observational in Severe aortic stenosis (n=173). Transapical-transcatheter aortic valve replacement (TA-TAVR) was evaluated on All-cause mortality. Transapical-transcatheter aortic valve replacement demonstrated satisfactory long-term outcomes in patients with severe aortic stenosis, with an overall survival rate of 22.1% at 8 years.
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