Key result
Transaxillary TAVR was associated with comparable 30-day mortality (OR 1.30; 95% CI 0.78-2.17; P=0.32) and 1-year mortality compared to transfemoral TAVR, despite higher baseline comorbidities.
Why the study?
While transfemoral access is default for TAVR, the preferred alternative access route remains unclear and transaxillary access has shown promise.
Does transaxillary TAVR provide comparable outcomes to transfemoral TAVR in patients receiving the CoreValve device?
Meta-Analysis (n=1,903)
Does transaxillary TAVR provide comparable outcomes to transfemoral TAVR in patients receiving the CoreValve device?
Odds Ratio: 1.3 (95% CI 0.78–2.17)
p-value: p=0.32
Transaxillary TAVR is a viable alternative access route with comparable mortality and potentially lower AKI rates compared to transfemoral TAVR in high-risk patients.
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TAx-TAVR yields comparable outcomes to TF-TAVR; supports alternative access in high-risk patients but leaves open need for RCTs.
Zhan et al. (2019) conducted a meta-analysis in Transcatheter aortic valve replacement (TAVR) (n=1,903). Transaxillary (TAx) transcatheter aortic valve replacement vs. Transfemoral (TF) transcatheter aortic valve replacement was evaluated on 30-day mortality (OR 1.30, 95% CI 0.78-2.17, p=0.32). Transaxillary TAVR was associated with comparable 30-day mortality (OR 1.30; 95% CI 0.78-2.17; P=0.32) and 1-year mortality compared to transfemoral TAVR, despite higher baseline comorbidities.
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