1. Early clinical outcomes after transaxillary versus transfemoral TAVI. Data from the Spanish TAVI registry
- Author
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Roberto Blanco-Mata, Alberto Berenguer, Pilar Jiménez-Quevedo, José Antonio Baz, Valentín Tascón-Quevedo, Cristóbal Urbano Carrillo, Álvaro Ortiz de Salazar, Joaquín Sánchez Gila, Manuel Villa, Livia L. Gheorghe, Sandra Casellas, José Moreu, Raúl Moreno, Dabit Arzamendi, Soledad Ojeda, Erika Muñoz-García, José Antonio Acevedo Díaz, José M. de la Torre Hernández, Ramiro Trillo, Ignacio Cruz-González, Bruno García del Blanco, Ignacio Pérez-Moreiras, Jaime Elízaga, Beatriz Vaquerizo, Miguel Artaiz, Raquel del Valle-Fernández, Geoffrey Yanes-Bowden, Agustín Albarrán, Rafael Ruiz-Salmerón, Luis Nombela-Franco, Luisa Salido, Garikoit Lasa-Larraya, and Valeriano Ruiz-Quevedo
- Subjects
medicine.medical_specialty ,Registry ,Transcatheter aortic ,Pacemaker implantation ,Transcatheter Aortic Valve Replacement ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,Registries ,Myocardial infarction ,Propensity Score ,Transaxillary access ,Transcatheter aortic valve implantation ,Access route ,business.industry ,Severe aortic stenosis ,Mortality rate ,Aortic Valve Stenosis ,General Medicine ,medicine.disease ,Total mortality ,Treatment Outcome ,Aortic Valve ,Propensity score matching ,Cardiology ,business - Abstract
Introduction and objectives: Transaxillary access (TXA) has become the most widely used alternative to transfemoral access (TFA) in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to compare total in-hospital and 30-day mortality in patients included in the Spanish TAVI registry who were treated by TXA or TFA access. Methods: We analyzed data from patients treated with TXA or TFA and who were included in the TAVI Spanish registry. In-hospital and 30-day events were defined according to the recommendations of the Valve Academic Research Consortium. The impact of the access route was evaluated by propensity score matching according to clinical and echocardiogram characteristics. Results: A total of 6603 patients were included; 191 (2.9%) were treated via TXA and 6412 via TFA access. After adjustment (n = 113 TXA group and n = 3035 TFA group) device success was similar between the 2 groups (94%, TXA vs 95%, TFA; P = .95). However, compared with the TFA group, the TXA group showed a higher rate of acute myocardial infarction (OR, 5.3; 95%CI, 2.0-13.8); P= .001), renal complications (OR, 2.3; 95%CI, 1.3-4.1; P = .003), and pacemaker implantation (OR, 1.6; 95%CI, 1.01-2.6; P = .03). The TXA group also had higher in-hospital and 30-day mortality rates (OR, 2.2; 95%CI, 1.04-4.6; P= .039 and OR, 2.3; 95%CI, 1.2-4.5; P = .01, respectively). Conclusions: Compared with ATF, TXA is associated with higher total mortality, both in-hospital and at 30 days. Given these results, we believe that TXA should be considered only in those patients who are not suitable candidates for TFA. (C) 2021 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
- Published
- 2021