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Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access

BACKGROUND: The purpose of this study was to compare the safety and clinical outcomes of transcarotid (TC) and transapical access (TA) transcatheter aortic valve implantation (TAVI) patients whom the transfemoral approach (TF) was not feasible. METHODS: The analysis included consecutive patients wit...

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Autores principales: Hudziak, Damian, Targoński, Radosław, Wańha, Wojciech, Gocoł, Radosław, Hajder, Adrianna, Parma, Radosław, Figatowski, Tomasz, Darocha, Tomasz, Deja, Marek A., Wojakowski, Wojciech, Jagielak, Dariusz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129253/
https://www.ncbi.nlm.nih.gov/pubmed/34308536
http://dx.doi.org/10.5603/CJ.a2021.0071
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author Hudziak, Damian
Targoński, Radosław
Wańha, Wojciech
Gocoł, Radosław
Hajder, Adrianna
Parma, Radosław
Figatowski, Tomasz
Darocha, Tomasz
Deja, Marek A.
Wojakowski, Wojciech
Jagielak, Dariusz
author_facet Hudziak, Damian
Targoński, Radosław
Wańha, Wojciech
Gocoł, Radosław
Hajder, Adrianna
Parma, Radosław
Figatowski, Tomasz
Darocha, Tomasz
Deja, Marek A.
Wojakowski, Wojciech
Jagielak, Dariusz
author_sort Hudziak, Damian
collection PubMed
description BACKGROUND: The purpose of this study was to compare the safety and clinical outcomes of transcarotid (TC) and transapical access (TA) transcatheter aortic valve implantation (TAVI) patients whom the transfemoral approach (TF) was not feasible. METHODS: The analysis included consecutive patients with severe symptomatic aortic stenosis treated from 2017 to 2020 with TC-TAVI or TA-TAVI in two high-volume TAVI centers. The approach was selected by multidisciplinary heart teams after analyzing multislice computed tomography of the heart, aorta and peripheral arteries, transthoracic echocardiography and coronary angiography. RESULTS: One hundred and two patients were treated with alternative TAVI accesses (TC; n = 49 and TA; n = 53) in our centers. The groups were similar regarding age, gender, New York Heart Association class, and echocardiography parameters. Patients treated with TC-TAVI had significantly higher surgical risk. The procedural success rate was similar in both groups (TC-TAVI 98%; TA-TAVI 98.1%; p = 0.95). The rate of Valve Academic Research Consortium-2 defined clinical events was low in both groups. The percentage of new-onset rhythm disturbances and permanent pacemaker implantation was similar in TC and TA TAVI (4.1% vs. 11.3%; p = 0.17 and 10.2% vs. 5.7%; p = 0.39, respectively). In the TA-TAVI group, significantly more cases of pneumonia and blood transfusions were observed (11% vs. 0%; p = 0.01 and 30.2% vs. 12.2%; p = 0.03). The 30-day mortality was similar in TC and TA groups (4.1% vs. 5.7%; p = 0.71, respectively). CONCLUSIONS: Both TC and TA TAVI are safe procedures in appropriately selected patients and are associated with a low risk of complications.
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spelling pubmed-101292532023-04-26 Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access Hudziak, Damian Targoński, Radosław Wańha, Wojciech Gocoł, Radosław Hajder, Adrianna Parma, Radosław Figatowski, Tomasz Darocha, Tomasz Deja, Marek A. Wojakowski, Wojciech Jagielak, Dariusz Cardiol J Interventional Cardiology BACKGROUND: The purpose of this study was to compare the safety and clinical outcomes of transcarotid (TC) and transapical access (TA) transcatheter aortic valve implantation (TAVI) patients whom the transfemoral approach (TF) was not feasible. METHODS: The analysis included consecutive patients with severe symptomatic aortic stenosis treated from 2017 to 2020 with TC-TAVI or TA-TAVI in two high-volume TAVI centers. The approach was selected by multidisciplinary heart teams after analyzing multislice computed tomography of the heart, aorta and peripheral arteries, transthoracic echocardiography and coronary angiography. RESULTS: One hundred and two patients were treated with alternative TAVI accesses (TC; n = 49 and TA; n = 53) in our centers. The groups were similar regarding age, gender, New York Heart Association class, and echocardiography parameters. Patients treated with TC-TAVI had significantly higher surgical risk. The procedural success rate was similar in both groups (TC-TAVI 98%; TA-TAVI 98.1%; p = 0.95). The rate of Valve Academic Research Consortium-2 defined clinical events was low in both groups. The percentage of new-onset rhythm disturbances and permanent pacemaker implantation was similar in TC and TA TAVI (4.1% vs. 11.3%; p = 0.17 and 10.2% vs. 5.7%; p = 0.39, respectively). In the TA-TAVI group, significantly more cases of pneumonia and blood transfusions were observed (11% vs. 0%; p = 0.01 and 30.2% vs. 12.2%; p = 0.03). The 30-day mortality was similar in TC and TA groups (4.1% vs. 5.7%; p = 0.71, respectively). CONCLUSIONS: Both TC and TA TAVI are safe procedures in appropriately selected patients and are associated with a low risk of complications. Via Medica 2023-04-17 /pmc/articles/PMC10129253/ /pubmed/34308536 http://dx.doi.org/10.5603/CJ.a2021.0071 Text en Copyright © 2023 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Interventional Cardiology
Hudziak, Damian
Targoński, Radosław
Wańha, Wojciech
Gocoł, Radosław
Hajder, Adrianna
Parma, Radosław
Figatowski, Tomasz
Darocha, Tomasz
Deja, Marek A.
Wojakowski, Wojciech
Jagielak, Dariusz
Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title_full Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title_fullStr Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title_full_unstemmed Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title_short Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
title_sort comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129253/
https://www.ncbi.nlm.nih.gov/pubmed/34308536
http://dx.doi.org/10.5603/CJ.a2021.0071
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