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July 1, 2012

This review compares the published outcomes of transapical versus transfemoral transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis.

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Why the study?

Does the transapical approach compared to the transfemoral approach improve outcomes in high risk or inoperable patients undergoing TAVI for severe aortic stenosis?

Population

High risk or surgically inoperable patients with severe symptomatic aortic stenosis

Comparison

Transcatheter aortic valve implantation via… vs Transcatheter aortic valve implantation via…

Design

Review

Key result

This review compares the published outcomes of transapical versus transfemoral transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis.

Authors

WGWilliam H. GaaschRDRichard S. D’Agostino

Discussion

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Member takes

Overview

Neither approach shows clear superiority in this review; leaves open need for randomized trials to guide TAVI access selection.

Key Points

  • The objective is to compare clinical outcomes of transapical versus transfemoral approaches in TAVI for patients with severe aortic stenosis.
  • Assess outcomes of TAVI from published studies and registries
  • Include prospective multicenter randomized study (PARTNER)
  • Focus on patients with severe symptomatic aortic stenosis, high risk for surgery or inoperable
  • Published data covers outcomes for over 5000 patients with TAVI
  • One prominent trial (PARTNER) provides comparative insights
  • Differences in clinical outcomes between approaches continue to evolve

Structured PICO

Does the transapical approach compared to the transfemoral approach improve outcomes in high risk or inoperable patients undergoing TAVI for severe aortic stenosis?

P
Population
A review of published results of TAVI in high-risk or inoperable patients with severe aortic stenosis, comparing transapical versus transfemoral techniques.
I
Intervention
Transcatheter aortic valve implantation (TAVI) via transapical approach
C
Comparator
Transcatheter aortic valve implantation (TAVI) via transfemoral approach

This review compares the transapical and transfemoral approaches for transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis.

Cite This Study

Gaasch et al. (2012) conducted a review in Severe symptomatic aortic stenosis. Transapical transcatheter aortic valve implantation (TAVI) vs. Transfemoral TAVI was evaluated. This review compares the published outcomes of transapical versus transfemoral transcatheter aortic valve implantation in high-risk or inoperable patients with severe aortic stenosis.

synapsesocial.com/papers/6a21cda1033871db2707ca1fhttps://doi.org/10.3978/j.issn.2225-319x.2012.07.02
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparing traditional aortic valve surgery and transapical approach to transcatheter aortic valve implant2020 · 13 citations
  2. 2Optimal pain management after aortic valve implantation: an opportunity to improve outcomes after transapical access in the future?2012 · 5 citations
  3. 3Transapical aortic valve implantation: a reasonable therapeutic option, but not the only alternative to transfemoral approach.2013 · 9 citations
  4. 4Transapical vs. transfemoral aortic valve implantation: Which approach for which patient, from a surgeon's standpoint.2012 · 23 citations
  5. 5Transcatheter aortic valve implantation (TAVI)2010 · 23 citations