Takahide Arai1, Mauro Romano2, Thierry Lefèvre3, Thomas Hovasse1, Arnaud Farge2, Daniel Le Houerou2, Kentaro Hayashida4, Yusuke Watanabe5, Philippe Garot1, Hakim Benamer1, Thierry Unterseeh1, Erik Bouvier1, Marie-Claude Morice1, Bernard Chevalier1. 1. Department of Interventional Cardiology, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France. 2. Department of Cardiovascular Surgery and Transcatheter Heart and Vascular Therapies, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France. 3. Department of Interventional Cardiology, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France. Electronic address: t.lefevre@angio-icps.com. 4. Department of Interventional Cardiology, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. 5. Department of Interventional Cardiology, Hopital Privé Jacques Cartier, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France; Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
Abstract
OBJECTIVES: The aim of this study was to compare outcomes among transfemoral (TF), transaortic (TAo), and transapical (TA) transcatheter aortic valve replacement (TAVR). BACKGROUND: Very few studies have investigated the differences among TF, TAo, and TA TAVR in terms of safety and feasibility. METHODS: Between January 2011 and December 2014, 467 consecutive cases of TF TAVR, 289 cases of TAo TAVR, and 42 cases of TA TAVR were analyzed. Baseline characteristics, procedural characteristics, and outcomes were compared between TF and TAo and between TAo and TA approaches. RESULTS: Balloon-expandable prostheses were used in 320 cases of TF TAVR (69%), 209 cases of TAo TAVR (72%), and all cases of TA TAVR. The remaining cases were performed using self-expandable prostheses. Patient age and Society of Thoracic Surgeons score were similar (83.8 years vs. 83.7 years vs. 81.3 years and 6.2% vs. 5.8% vs. 7.1%) among all groups. Although nonsignificant, a trend toward lower 30-day mortality (5% vs. 9%; p = 0.057) was observed with TF TAVR compared with TAo TAVR. Kaplan-Meier analysis revealed a trend toward a higher 1-year survival rate (log-rank p = 0.067) with TF TAVR compared with TAo TAVR. There was no significant difference in 30-day mortality between TAo and TA TAVR (9% vs. 14%; p = 0.283). Kaplan-Meier analysis revealed a trend toward a higher 1-year survival rate (log-rank p = 0.154) with TAo TAVR compared with TA TAVR. CONCLUSIONS: Although the 30-day mortality and 1-year survival rates were similar between TF and TAo TAVR patients, a trend in favor of the TF approach was observed. In addition, the TAo approach can be considered as an alternative to the TA approach when the TF approach seems unsuitable.
OBJECTIVES: The aim of this study was to compare outcomes among transfemoral (TF), transaortic (TAo), and transapical (TA) transcatheter aortic valve replacement (TAVR). BACKGROUND: Very few studies have investigated the differences among TF, TAo, and TA TAVR in terms of safety and feasibility. METHODS: Between January 2011 and December 2014, 467 consecutive cases of TF TAVR, 289 cases of TAo TAVR, and 42 cases of TA TAVR were analyzed. Baseline characteristics, procedural characteristics, and outcomes were compared between TF and TAo and between TAo and TA approaches. RESULTS: Balloon-expandable prostheses were used in 320 cases of TF TAVR (69%), 209 cases of TAo TAVR (72%), and all cases of TA TAVR. The remaining cases were performed using self-expandable prostheses. Patient age and Society of Thoracic Surgeons score were similar (83.8 years vs. 83.7 years vs. 81.3 years and 6.2% vs. 5.8% vs. 7.1%) among all groups. Although nonsignificant, a trend toward lower 30-day mortality (5% vs. 9%; p = 0.057) was observed with TF TAVR compared with TAo TAVR. Kaplan-Meier analysis revealed a trend toward a higher 1-year survival rate (log-rank p = 0.067) with TF TAVR compared with TAo TAVR. There was no significant difference in 30-day mortality between TAo and TA TAVR (9% vs. 14%; p = 0.283). Kaplan-Meier analysis revealed a trend toward a higher 1-year survival rate (log-rank p = 0.154) with TAo TAVR compared with TA TAVR. CONCLUSIONS: Although the 30-day mortality and 1-year survival rates were similar between TF and TAo TAVR patients, a trend in favor of the TF approach was observed. In addition, the TAo approach can be considered as an alternative to the TA approach when the TF approach seems unsuitable.
Authors: Marvin H Eng; Pedro Villablanca; Tiberio Frisoli; Adam B Greenbaum; William W O'Neill Journal: Curr Cardiol Rep Date: 2019-10-31 Impact factor: 2.931
Authors: F van Kesteren; M S van Mourik; E M A Wiegerinck; J Vendrik; J J Piek; J G Tijssen; K T Koch; J P S Henriques; J J Wykrzykowska; R J de Winter; A H G Driessen; A Kaya; R N Planken; M M Vis; J Baan Journal: Neth Heart J Date: 2018-09 Impact factor: 2.380