Document Type
Article
Publication Title
JTCVS Tech
Abstract
UNLABELLED: Transaxillary access has been the most frequently used nonfemoral access route for transcatheter aortic valve replacement (TAVR) with a self-expanding valve. Use of transcarotid TAVR is increasing; however, comparative data on these methods are limited. We compared outcomes following transcarotid or transaxillary TAVR with a self-expanding, supra-annular valve.
METHODS: The Transcatheter Valve Therapy Registry was queried for TAVR procedures using transaxillary and transcarotid access between July 2015 and June 2021. Patients received a self-expanding Evolut R, PRO, or PRO + valve (Medtronic) and had 1-year follow-up. Thirty-day and 1-year outcomes were compared in transcarotid and transaxillary groups after 1:2 propensity score-matching. Multivariable regression models were fitted to identify predictors of key end points.
RESULTS: The propensity score-matched cohort included 576 patients receiving transcarotid and 1142 receiving transaxillary access. Median procedure time (99 vs 118 minutes;
CONCLUSIONS: Transcarotid versus transaxillary access for TAVR using a self-expanding valve is associated with procedural benefits and significantly lower stroke and mortality or stroke at 30 days. In patients with unsuitable femoral anatomy, transcarotid access may be the preferred delivery route for self-expanding valves.
First Page
45
Last Page
55
DOI
10.1016/j.xjtc.2023.07.019
Publication Date
10-1-2023
Recommended Citation
Allen, Keith B; Watson, Daniel; Vora, Amit N; Mahoney, Paul; Chhatriwalla, Adnan K; Schwartz, Jonathan G; Keller, Antoine; Sodhi, Nishtha; Haugan, Daniel; and Caskey, Michael, "Transcarotid versus transaxillary access for transcatheter aortic valve replacement with a self-expanding valve: A propensity-matched analysis." (2023). Heart and Vascular Articles. 14.
https://scholarlyworks.ohiohealth.com/heart-vascular-articles/14