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July 1, 2012

Transapical transcatheter aortic valve replacement provides an effective alternative for patients with severe aortic stenosis and complex aortoiliac disease, with experienced centers achieving short-term mortality rates comparable to transfemoral approaches.

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Population

Elderly, frail patients with severe symptomatic aortic stenosis

Design

Review

Key result

Transapical transcatheter aortic valve replacement provides an effective alternative for patients with severe aortic stenosis and complex aortoiliac disease, with experienced centers achieving short-term mortality rates comparable to transfemoral approaches.

Authors

CSChristian ShultsRBRebecca Bassett‐GunterVTVinod H. Thourani

Discussion

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Overview

May support TA-TAVR consideration in experienced centers for complex anatomy; leaves open need for randomized comparisons.

Key Points

  • This research examines the role and efficacy of transapical aortic valve replacement (TA-TAVR) and its potential benefits over traditional methods.
  • Evaluated indications and outcomes of TA-TAVR before and after SAPIEN XT valve development.
  • Compared transapical techniques with other approaches to identify advantages and patient suitability.
  • Explored theoretical advancements in valvular therapies linked to transapical access.
  • Enhanced patient eligibility for TAVR due to improvements in technology and technique.
  • Transapical approach shows promising outcomes for patients with severe aortic stenosis and complex anatomical challenges.
  • Potential for TA-TAVR to inform future strategies for other valvular interventions.

Structured PICO

P
Population
A review of patients with severe symptomatic aortic stenosis who are high-risk or ineligible for traditional surgical aortic valve replacement, evaluated for transapical transcatheter valve therapies.
I
Intervention
Transapical (TA) transcatheter aortic valve replacement (TAVR)

This review evaluates the role, indications, outcomes, and future potential of the transapical approach for transcatheter aortic valve replacement.

Limitations

  • More invasive nature requiring a rib-spreading thoracotomy
  • Prolonged postoperative pain with delayed recovery
  • Higher incidence of intra- and post-operative bleeding, with 10-20% of patients requiring blood transfusions

Cite This Study

Shults et al. (2012) conducted a review in Severe symptomatic aortic stenosis. Transapical transcatheter aortic valve replacement (TA-TAVR) vs. Surgical aortic valve replacement (SAVR) or Transfemoral TAVR was evaluated. Transapical transcatheter aortic valve replacement provides an effective alternative for patients with severe aortic stenosis and complex aortoiliac disease, with experienced centers achieving short-term mortality rates comparable to transfemoral approaches.

synapsesocial.com/papers/6a35da49a4e90ae4d3ef502chttps://doi.org/10.3978/j.issn.2225-319x.2012.06.14
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Also Consider

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

  1. 1Transapical vs. transfemoral aortic valve implantation: Which approach for which patient, from a surgeon's standpoint.2012 · 23 citations
  2. 2Illustrated techniques for transapical aortic valve implantation.2012 · 26 citations
  3. 3Transaortic access is the key to success2013 · 36 citations
  4. 4Optimal pain management after aortic valve implantation: an opportunity to improve outcomes after transapical access in the future?2012 · 5 citations
  5. 5Transcatheter aortic valve implantation (TAVI)2010 · 23 citations