Key result
Transapical TAVR had fewer vascular complications (0% vs 9%, p=0.003) and less mild-moderate paravalvular regurgitation (24.2% vs 43.5%, p=0.006) compared to the transfemoral approach.
Why the study?
Does transapical transcatheter aortic valve replacement reduce complications compared to the transfemoral approach in patients with severe aortic valve stenosis?
Population
200 patients with severe aortic valve stenosis, median age 82, 55% male, STS predicted risk of mortality 8.1%.
Comparison
Transapical transcatheter aortic valve replacement vs Transfemoral transcatheter aortic valve…
Design
Cohort
Follow-up
Operative/discharge
Authors
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Transapical TAVR was associated with fewer vascular complications and less regurgitation; hypothesis-generating and should not yet change practice.
Cohort (n=200)
Does transapical transcatheter aortic valve replacement reduce complications compared to the transfemoral approach in patients with severe aortic valve stenosis?
Absolute Event Rate: 49% vs 43%
p-value: p=0.478
Beyond the learning curve, transapical TAVR was associated with fewer vascular complications and less paravalvular regurgitation compared to transfemoral TAVR, with similar operative mortality.
Greason et al. (2014) conducted a cohort in Severe Aortic Valve Stenosis (n=200). Transapical transcatheter aortic valve replacement vs. Transfemoral transcatheter aortic valve replacement was evaluated on Operative complications (p=0.478). Transapical TAVR had fewer vascular complications (0% vs 9%, p=0.003) and less mild-moderate paravalvular regurgitation (24.2% vs 43.5%, p=0.006) compared to the transfemoral approach.
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