Short- and Mid-Term Outcomes in Patients Deemed Inoperable Undergoing Transapical and Transfemoral TAVR with an STS-PROM below Four Percent

Transapical (TA) TAVR is known to be associated with increased mortality and vascular complications compared with transfemoral (TF) TAVR in high-risk and inoperable patients. However, safe alternative access methods remain crucial. We aimed to (1) evaluate the 30-day and 1-year outcomes comparing TA and TF TAVR in patients with an STS-PROM of <4% deemed inoperable and (2) determine dependent and independent predictors for all-cause one-year mortality. Data were collected from a single-center registry consisting of 340 eligible patients. One-to-one propensity score matching was performed (n = 50 TA, n = 50 TF). Primary endpoints were all-cause mortality, stroke, and major bleeding. Predictors for all-cause one-year mortality were evaluated. Thirty-day mortality (TF vs. TA: 0.0% vs. 4.0%; p = 0.153) was comparable in both cohorts. One-year all-cause mortality was twice as high in TA patients (TF vs. TA: 10.0% vs. 20.0%, p logrank = 0.165, HR 2.10). Cerebrovascular events and major bleeding during one-year follow-up were similar. The multivariate analysis identified hemoglobin <12 g/dL at admission and dual antiplatelet therapy as strong predictors for one-year mortality. Although femoral access is the primary access with favorable 30-day and 1-year results, transapical access was successful for patients unsuitable for TF TAVR, showing acceptable short- and mid-term results in inoperable patients with low-risk profiles. View Full-Text

Keywords: TAVR; TAVI; transfemoral; transapical; outcome

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MDPI and ACS Style

Veulemans, V.; Hellhammer, K.; Borhan Azad, A.; Goh, S.; Drake, C.; Maier, O.; Piayda, K.; Polzin, A.; Mehdiani, A.; Jung, C.; Westenfeld, R.; Kelm, M.; Lichtenberg, A.; Zeus, T. Short- and Mid-Term Outcomes in Patients Deemed Inoperable Undergoing Transapical and Transfemoral TAVR with an STS-PROM below Four Percent. J. Clin. Med. 2021, 10, 2993. https://doi.org/10.3390/jcm10132993

AMA Style

Veulemans V, Hellhammer K, Borhan Azad A, Goh S, Drake C, Maier O, Piayda K, Polzin A, Mehdiani A, Jung C, Westenfeld R, Kelm M, Lichtenberg A, Zeus T. Short- and Mid-Term Outcomes in Patients Deemed Inoperable Undergoing Transapical and Transfemoral TAVR with an STS-PROM below Four Percent. Journal of Clinical Medicine. 2021; 10(13):2993. https://doi.org/10.3390/jcm10132993

Chicago/Turabian Style

Veulemans, Verena, Katharina Hellhammer, Armin Borhan Azad, Shouheng Goh, Christian Drake, Oliver Maier, Kerstin Piayda, Amin Polzin, Arash Mehdiani, Christian Jung, Ralf Westenfeld, Malte Kelm, Artur Lichtenberg, and Tobias Zeus. 2021. "Short- and Mid-Term Outcomes in Patients Deemed Inoperable Undergoing Transapical and Transfemoral TAVR with an STS-PROM below Four Percent" Journal of Clinical Medicine 10, no. 13: 2993. https://doi.org/10.3390/jcm10132993

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Short- and Mid-Term Outcomes in Patients Deemed Inoperable Undergoing Transapical and Transfemoral TAVR with an STS-PROM below Four Percent

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