Key result
Transaortic TAVR shows no significant 30-day safety benefit over transapical TAVR in inoperable aortic stenosis.
Why the study?
Many TAVR candidates have inadequate iliofemoral vessels for transfemoral access, and the transapical alternative is associated with less favorable outcomes, requiring exploration of other access routes.
Does the transaortic approach for TAVR improve procedural and 30-day clinical outcomes compared to the transapical approach in patients with inoperable severe aortic stenosis ineligible for transfemoral access?
Comparison
TAO TAVR vs TAP TAVR
Design
Single-center comparative cohort study
Follow-up
30 days
Authors
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TAO TAVR may be feasible with fewer bleeding events than transapical in TF-ineligible patients; leaves open comparative outcomes in prospective studies.
Cohort (n=120)
No
Does the transaortic approach for TAVR improve procedural and 30-day clinical outcomes compared to the transapical approach in patients with inoperable severe aortic stenosis ineligible for transfemoral access?
Absolute Event Rate: 20% vs 33%
p-value: p=0.21
The transaortic approach for TAVR is a feasible and safe alternative to the transapical approach for patients with inoperable severe aortic stenosis who are ineligible for transfemoral access, potentially offering shorter ICU stays and fewer bleeding/vascular events.
Lardizabal et al. (2013) conducted a cohort in inoperable, severe aortic stenosis (n=120). Transaortic (TAO) TAVR vs. Transapical (TAP) TAVR was evaluated on 30-day combined safety endpoint of all-cause mortality, myocardial infarction, major stroke, disabling bleeding, severe acute kidney injury, and valve reintervention (p=0.21). Transaortic TAVR resulted in a 30-day combined safety endpoint rate of 20% compared to 33% for transapical TAVR in patients with inoperable aortic stenosis (p=0.21).
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