Network Meta-Analysis Comparing the Short- and Long-Term Outcomes of Alternative Access for Transcatheter Aortic Valve Replacement

Ranka, Sagar; Lahan, Shubham; Chhatriwalla, Adnan K.; Allen, Keith B.; Chiang, Michael; O’Neill, Brian; Verma, Sadhika; Wang, Dee Dee; Lee, James; Frisoli, Tiberio; Eng, Marvin H.; Bagur, Rodrigo; O’Neill, William W.; Villablanca, Pedro

doi:10.1016/j.carrev.2021.11.040

Cited by 12 publications

(7 citation statements)

References 59 publications

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“…A previous meta -analysis by Zhan et al [48] of 5 studies comparing the TF and TSc/TAx and another network meta -analysis [49] comparing several access sites demonstrated a lower but statistically non-significant 1-year mortality with the TF group, while our study showed statistically significant lower 1 year mortality in the TF group. Our present meta -analysis included 21 studies with subclavian/transaxillary and 75,995 patients.…”

Section: Discussioncontrasting

confidence: 55%

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Abusnina¹,

Balakrishna²,

Ismayl³

et al. 2022

IJC Heart & Vasculature

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Section: Discussioncontrasting

confidence: 55%

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Abusnina¹,

Balakrishna²,

Ismayl³

et al. 2022

IJC Heart & Vasculature

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“…Indeed, transcarotid access has been used for transcatheter aortic valve implantation for some time, with similar safety to transfemoral access. 11 …”

Section: Discussionmentioning

confidence: 99%

Transcarotid implantation of a leadless pacemaker in a patient with Fontan circulation

Calvert

Yeo

Rao

et al. 2023

HeartRhythm Case Reports

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“…However, transapical access has been associated with higher mortality. [24][25][26] Patients with PVD with involvement of the peripheral VB present a unique challenge for vascular access driven by vascular anatomy, calcifications, or history of peripheral vascular interventions. These factors also drive major vascular and bleeding complications, which were more common in patients with versus without PVD.…”

Section: Discussionmentioning

confidence: 99%

Association Between Polyvascular Disease and Transcatheter Aortic Valve Replacement Outcomes: Insights From the STS/ACC TVT Registry

Bansal,

Soni,

Shah

et al. 2023

Circ: Cardiovascular Interventions

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Background: Atherosclerotic cardiovascular disease (ASCVD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). Polyvascular disease (PVD), defined as involvement of ≥2 vascular beds (VB) i.e., coronary, cerebrovascular, or peripheral, portends a poor prognosis in patients with ASCVD; however, data on the association of PVD with outcomes of patients undergoing TAVR are limited. Methods: The Society of Thoracic Surgeons and the American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry was analyzed to identify patients who underwent TAVR from November 2011 through March 2022. Exposure of interest was PVD. Primary outcome was all-cause mortality. Secondary outcomes included major vascular complications, major/life-threatening bleeding, myocardial infarction (MI), transient ischemic attack (TIA)/stroke, and valve and non-valve related readmissions. Outcomes were assessed at 30 days and 1 year. Results: Of 443,790 patients who underwent TAVR, PVD was present in 150,823 (34.0%) [111,425 (25.1%) with 2VB-PVD and 39,398 (8.9%) with 3VB-PVD]. On multivariable analysis, PVD was associated with increased all-cause mortality at 1 year (hazard ratio [HR] 1.17; 95% CI, 1.14-1.20). There was an incremental increase in 1-year mortality with increasing number of VB involved (no PVD [ref.], 2VB-PVD, HR 1.12; 95% CI, 1.09-1.15, and 3VB-PVD, HR 1.31; 95% CI, 1.26-1.36). Patients with vs. without PVD had higher rates of major vascular complications, major/life-threatening bleeding, TIA/stroke, and non-valve related readmissions at 30 days and 1 year. Conclusions: PVD is associated with worse outcomes after TAVR, and the risk is highest in patients with 3VB-PVD.

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Network Meta-Analysis Comparing the Short- and Long-Term Outcomes of Alternative Access for Transcatheter Aortic Valve Replacement

Cited by 12 publications

References 59 publications

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Transcarotid implantation of a leadless pacemaker in a patient with Fontan circulation

Association Between Polyvascular Disease and Transcatheter Aortic Valve Replacement Outcomes: Insights From the STS/ACC TVT Registry

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