Comparative Analysis of Percutaneous vs. Surgical Access in Transfemoral TAVR: A Propensity-Matched Cohort Study.

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Hellenic Journal of Cardiology Pub Date : 2025-03-07 DOI:10.1016/j.hjc.2025.03.003

Georgios E Papadopoulos, Ilias Ninios, Eleftherios Leptopoulos, Konstantinos Papazoglou, Konstantinos Konstantinidis, Sotirios Evangelou, Andreas Ioannides, Vlasis Ninios

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Abstract

Background: Transcatheter aortic valve replacement (TAVR) is a proven treatment for severe aortic stenosis (AS). Transfemoral access is the most prevalent method, achieved either surgically or percutaneously. This study compares in-hospital outcomes and length of stay between surgical cut-down and fully percutaneous approaches.

Methods: This retrospective, propensity-matched study analyzed medical records of all patients who underwent transfemoral TAVR at our center from January 2019 to December 2023. Outcomes were assessed based on Valve Academic Research Consortium-2 (VARC-2) consensus criteria.

Results: 251 TAVR patients (77 propensity score matching pairs) were included (55% female) with a median (IQR) age of 80 (11) years. Surgical cut-down showed fewer vascular complications, bleeding, and transfusions. No death was re-ported in this group. Fewer mean hospitalization days were observed in the total cohort over the years (p< 0.001). This reduction was more pronounced after 2021 when the surgical approach was adopted. Mean hospitalization days were 6.40 ±6.46 for percutaneous and 4.34 ±1.61 for surgical groups (p< 0.001).

Conclusions: Surgical cut-down for TAVR femoral access yields superior outcomes and shorter hospital stays compared to fully percutaneous methods.

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.