Percutaneous vs. surgical axillary access for transcatheter aortic valve implantation: the TAXI registry
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Percutaneous vs. surgical axillary access for transcatheter aortic valve implantation: the TAXI registry. / Giordano, Arturo; Schaefer, Andreas; Bhadra, Oliver D; Conradi, Lenard; Westermann, Dirk; DE Backer, Ole; Bajoras, Vilhelmas; Sondergaard, Lars; Qureshi, Waqas T; Kakouros, Nikolaos; Aldrugh, Summer; Amat-Santos, Ignacio; Santos Martínez, Sandra; Kaneko, Tsuyoshi; Harloff, Morgan; Teles, Rui; Nolasco, Tiago; Neves, Jose P; Abecasis, Miguel; Werner, Nikos; Lauterbach, Michael; Sacha, Jerzy; Krawczyk, Krzysztof; Trani, Carlo; Romagnoli, Enrico; Mangieri, Antonio; Condello, Francesco; Regueiro, Ander; Brugaletta, Salvatore; Biancari, Fausto; Niemelä, Matti; Giannini, Francesco; Toselli, Marco; Ruggiero, Rossella; Buono, Andrea; Maffeo, Diego; Bruno, Francesco; Conrotto, Federico; D'Ascenzo, Fabrizio; Savontaus, Mikko; Pykäri, Jouni; Ielasi, Alfonso; Tespili, Maurizio; Corcione, Nicola; Ferraro, Paolo; Morello, Alberto; Albanese, Michele; Biondi-Zoccai, Giuseppe.
in: PANMINERVA MED, Jahrgang 64, Nr. 4, 12.2022, S. 427-437.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Percutaneous vs. surgical axillary access for transcatheter aortic valve implantation: the TAXI registry
AU - Giordano, Arturo
AU - Schaefer, Andreas
AU - Bhadra, Oliver D
AU - Conradi, Lenard
AU - Westermann, Dirk
AU - DE Backer, Ole
AU - Bajoras, Vilhelmas
AU - Sondergaard, Lars
AU - Qureshi, Waqas T
AU - Kakouros, Nikolaos
AU - Aldrugh, Summer
AU - Amat-Santos, Ignacio
AU - Santos Martínez, Sandra
AU - Kaneko, Tsuyoshi
AU - Harloff, Morgan
AU - Teles, Rui
AU - Nolasco, Tiago
AU - Neves, Jose P
AU - Abecasis, Miguel
AU - Werner, Nikos
AU - Lauterbach, Michael
AU - Sacha, Jerzy
AU - Krawczyk, Krzysztof
AU - Trani, Carlo
AU - Romagnoli, Enrico
AU - Mangieri, Antonio
AU - Condello, Francesco
AU - Regueiro, Ander
AU - Brugaletta, Salvatore
AU - Biancari, Fausto
AU - Niemelä, Matti
AU - Giannini, Francesco
AU - Toselli, Marco
AU - Ruggiero, Rossella
AU - Buono, Andrea
AU - Maffeo, Diego
AU - Bruno, Francesco
AU - Conrotto, Federico
AU - D'Ascenzo, Fabrizio
AU - Savontaus, Mikko
AU - Pykäri, Jouni
AU - Ielasi, Alfonso
AU - Tespili, Maurizio
AU - Corcione, Nicola
AU - Ferraro, Paolo
AU - Morello, Alberto
AU - Albanese, Michele
AU - Biondi-Zoccai, Giuseppe
PY - 2022/12
Y1 - 2022/12
N2 - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established management strategy for severe aortic valve stenosis. Percutaneous axillary approach for TAVI holds the promise of improving safety without jeopardizing effectiveness in comparison to surgical access. We aimed at appraising the comparative effectiveness of percutaneous vs. surgical axillary approaches for TAVI.METHODS: We performed an international retrospective observational study using de-identified details on baseline, procedural, and 1-month follow-up features. Valve Academic Research Consortium (VARC)-3 criteria were applied throughout. Outcomes of interest were clinical events up to 1 month of follow-up, compared with unadjusted and propensity score-adjusted analyses.RESULTS: A total of 432 patients were included, 189 (43.8%) receiving surgical access, and 243 (56.2%) undergoing percutaneous access. Primary hemostasis failure was more common in the percutaneous group (13.2% vs. 4.2%, P<0.001), leading to more common use of covered stent implantation (13.2% vs. 3.7%, P<0.001). Irrespectively, percutaneous access was associated with shorter hospital stay (-2.6 days [95% confidence interval: -5.0; -0.1], P=0.038), a lower risk of major adverse events (a composite of death, myocardial infarction, stroke, type 3 bleeding, and major access-site related complication; odds ratio=0.44 [0.21; 0.95], P=0.036), major access-site non-vascular complications (odds ratio=0.21 [0.06; 0.77], P=0.018), and brachial plexus impairment (odds ratio=0.16 [0.03; 0.76], P=0.021), and shorter hospital stay (-2.6 days [-5.0; -0.1], P=0.038).CONCLUSIONS: Percutaneous axillary access provides similar or better results than surgical access in patients undergoing TAVI with absolute or relative contraindications to femoral access.
AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established management strategy for severe aortic valve stenosis. Percutaneous axillary approach for TAVI holds the promise of improving safety without jeopardizing effectiveness in comparison to surgical access. We aimed at appraising the comparative effectiveness of percutaneous vs. surgical axillary approaches for TAVI.METHODS: We performed an international retrospective observational study using de-identified details on baseline, procedural, and 1-month follow-up features. Valve Academic Research Consortium (VARC)-3 criteria were applied throughout. Outcomes of interest were clinical events up to 1 month of follow-up, compared with unadjusted and propensity score-adjusted analyses.RESULTS: A total of 432 patients were included, 189 (43.8%) receiving surgical access, and 243 (56.2%) undergoing percutaneous access. Primary hemostasis failure was more common in the percutaneous group (13.2% vs. 4.2%, P<0.001), leading to more common use of covered stent implantation (13.2% vs. 3.7%, P<0.001). Irrespectively, percutaneous access was associated with shorter hospital stay (-2.6 days [95% confidence interval: -5.0; -0.1], P=0.038), a lower risk of major adverse events (a composite of death, myocardial infarction, stroke, type 3 bleeding, and major access-site related complication; odds ratio=0.44 [0.21; 0.95], P=0.036), major access-site non-vascular complications (odds ratio=0.21 [0.06; 0.77], P=0.018), and brachial plexus impairment (odds ratio=0.16 [0.03; 0.76], P=0.021), and shorter hospital stay (-2.6 days [-5.0; -0.1], P=0.038).CONCLUSIONS: Percutaneous axillary access provides similar or better results than surgical access in patients undergoing TAVI with absolute or relative contraindications to femoral access.
KW - Humans
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
KW - Aortic Valve Stenosis/surgery
KW - Registries
KW - Retrospective Studies
KW - Aortic Valve/surgery
KW - Risk Factors
U2 - 10.23736/S0031-0808.22.04750-4
DO - 10.23736/S0031-0808.22.04750-4
M3 - SCORING: Journal article
C2 - 35638242
VL - 64
SP - 427
EP - 437
JO - PANMINERVA MED
JF - PANMINERVA MED
SN - 0031-0808
IS - 4
ER -