Preferred Transaxillary Versus Transfemoral Access in Transcatheter Aortic Valve Implantation: A Propensity Matched Analysis

• DOI: 10.2139/ssrn.4491393
• Publication Date: 2023-07-14T13:59:24Z
• Authors: Marleen van Wely; Astrid van Nieuwkerk; Maxim Rooijakkers; Kees van der Wulp; Helmut Gehlmann; Michel Verkroost; Leen van Garsse; Guillaume Geuzebroek; José Antonio Baz; Didier Tchetche; Fabio De Brito jr; Marco Barbanti; Ran Kornowski; Azeem Latib; Augusto D’Onofrio; Flavio Ribichini; George D. Dangas; Roxana Mehran; Ronak Delewi; Niels van Royen

Background:Historically, transfemoral (TF) access is the default in TAVI. Iliofemoral tortuosity, calcification and stenosis may impose risk of complications or preclude femoral access. When precluded, transsubclavian /transaxillary (Tax) has been shown to be a safe alternative. Whether TAx as primary site similar safety efficacy TF for TAVI procedures unknown. The aim this study was compare outcomes between patients with severe symptomatic aortic valve treated self-expanding devices using / transaxillary (TAx) route transcatheter implantation (TAVI).Methods: A single center cohort 362 were multi-center 5980 Propensity score matching used reduce selection bias potential confounding. After propensity 322 each group compared.Results:The 30-day one-year all-cause mortality both groups (30 days: 5% versus 6%, p=0.90; 1 year: 20% 16%, p=0.17). Secondary included clinical in-hospital groups, except myocardial infarction (TAx 4% 1%, p=0.05) new permanent pacemaker 12% 21%, p=0.001).Conclusion: feasible that are comparable