Device stratified comparison among transfemoral, transapical and transubclavian access for Transcatheter Aortic Valve Replacement (TAVR): A meta-analysis

García, Daniel; Benjo, Alexandre; Cardoso, Rhanderson; Macedo, Francisco; Chavez, Patricia; Aziz, Emad F.; Herzog, Eyal; Alam, Mahboob; Marchena, Eduardo de

doi:10.1016/j.ijcard.2013.12.162

Cited by 15 publications

(18 citation statements)

References 10 publications

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“…This could be explained by the higher rate (32.6%) of performing TAVI with other angioplasty procedures, compared to other studies. 27 – 29 In line with almost all TAVI studies, our echocardiography data demonstrated immediate and sustained relief of pressure overload on the left ventricle, which translated into a significant increase in AVA and LVEF, in addition to significant reduction in the pressure gradient across AV, as well as improvement of PASP. 13 – 21 …”

Section: Discussionsupporting

confidence: 81%

“… 27 On the other hand, transfemoral TAVI carries a higher risk of vascular access complications, needs more volume of contrast and more exposure to radiation compared to transapical. 27 – 29 However, our TAVI procedures were carried out within an acceptable mean fluoroscopy time of 23 (9) minutes, but the mean amount of contrast required 135 (54) mL, was more than expected. This could be explained by the higher rate (32.6%) of performing TAVI with other angioplasty procedures, compared to other studies.…”

Section: Discussionmentioning

confidence: 85%

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Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia

Alatawi

Abuelatta

AlAhmedi

et al. 2018

Annals of Saudi Medicine

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BACKGROUNDTranscatheter aortic valve implantation (TAVI) has been recognized as a valid alternative to surgery for severe aortic valve stenosis (AS) in high-risk surgical patients.OBJECTIVEDetermine first-year clinical outcomes for TAVI at Madinah Cardiac Center (MMC) in Saudi Arabia.DESIGNRetrospective, analytical cross-sectional.SETTINGTertiary cardiac care center.PATIENTS AND METHODSAll patients who underwent TAVI for severe AS between February 2013 and December 2016 were included. Clinical, imaging, and laboratory information at baseline and at one year follow-up were analyzed.MAIN OUTCOME MEASURESClinical and echocardiography outcomes at discharge, at 1-month, and at end of follow-up; one-year mortality, complications and clinical response to TAVI procedure.SAMPLE SIZE AND CHARACTERISTICSN=80, mean (SD) age 79.5 (10.6) years, with severe AS and high-surgical risk.RESULTSFifty-five (69.2%) patients received Core valves, and 25 (30.8%) received Edward valves. Peri-procedure mortality was 3.8% and 1-year post-operative mortality was 13.8%. Ten patients (12.5%) had life-threatening or major bleeding. Nineteen (23.8%) patients had vascular complications, which were mostly minor. Fourteen patients (17.5%) developed acute kidney injury and 86% of these patients recovered. Five patients (6.25%) had pericardial effusion. Two patients (2.5%) developed endocarditis and another 2 patients (2.5%) had cerebrovascular accidents. Five patients (6.25%) received pacemakers. Mean aortic valve gradient significantly reduced from a mean (SD) 47.6 (19) mm Hg to 10.7 (6.0) mm Hg (P<.001). New York Heart Association functional class was significantly reduced (P<.001).CONCLUSIONThe TAVI experience at MCC is encouraging and comparable to international outcomes in terms of success, morbidity, and mortality rate.LIMITATIONSRetrospective, relatively small sample size. Rate of minor bleeding was overestimated.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 85%

Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia

Alatawi

Abuelatta

AlAhmedi

et al. 2018

Annals of Saudi Medicine

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“…Additionally, same studies suggest that, as compared to TF approach, TSc TAVI may present lower rate of vascular complications with comparable rates of other major outcomes despite the worse baseline profile of patients who are considered inappropriate for TF procedures [3,11]. Moreover, fully-percutaneous TSc approach can be successfully performed with low rate of complications as was recently proposed by some authors [12].…”

mentioning

confidence: 85%

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Amat‐Santos

Rojas

Gutiérrez

et al. 2018

Cathet Cardio Intervent

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“…Studies reveal a reduction in vascular complication rate using transapical and trans-subclavian access compared to a fully percutaneous femoral access. While this is easily understood for the transapical access due to its inherent features, data for the trans-subclavian are difficult to explain [39] .…”

Section: Comparison Among Access Sitementioning

confidence: 99%

“…On the other hand, the trans-apical approach is a more invasive procedure and involves a higher rate of surgical conversion, longer hospitalization, a higher rate of renal failure and higher mortality rates than the TF route [41] . Furthermore, no statistically significant differences are reported in stroke incidence and new pacemaker implantation using the trans-apical compare to the femoral access [39][40][41] .…”

Section: Comparison Among Access Sitementioning

confidence: 99%

Vascular approaches and its potential implications in transcatheter aortic valve implantation

Sticchi¹,

Bressi²,

Nusca³

et al. 2018

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Transcatheter aortic valve implantation (TAVI) has become in the last years a primary therapeutic tool in order to treat percutaneously severe aortic stenosis in frail patients with multiple comorbidity and a high surgical risk. In almost all cases, the complexity of patients who are candidates for TAVI is also reflected in challenging access sites. This vascular issue addresses the invasive play of constantly evolving devices and resulting complications have a considerable impact on patient morbidity and mortality. For this reason, the study and the choice of the different access site require the attention and experience of the operators to reach the most reliable and feasible vascular approach for a real procedural success.

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Device stratified comparison among transfemoral, transapical and transubclavian access for Transcatheter Aortic Valve Replacement (TAVR): A meta-analysis

Cited by 15 publications

References 10 publications

Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia

Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Vascular approaches and its potential implications in transcatheter aortic valve implantation

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