Meta‐analysis of transfemoral TAVR versus surgical aortic valve replacement

Meta‐analysis of transfemoral TAVR versus surgical aortic valve replacement INTRODUCTIONThe results of the original Placement of AoRTic TraNscathetER Valve (PARTNER) trial and the U.S CoreValve Pivotal Study demonstrated the feasibility of transcatheter aortic valve replacement (TAVR) in high‐ and prohibitive‐risk patients and have led to its widespread acceptance as an option for patients with severe aortic stenosis who could not undergo surgery, and as an acceptable alternative to surgical aortic valve replacement (SAVR) in high‐risk surgical risk patients . Recently, the PARTNER 2 trial found comparable outcomes for TAVR as compared to SAVR in intermediate‐risk patients and led to the approval of TAVR as an alternative to SAVR in intermediate‐surgical‐risk cohort . However, transfemoral TAVR (TF‐TAVR) specifically was associated with lower risks of death and disabling strokes. In the transthoracic cohort which included patients undergoing TAVR through transapical (TA‐TAVR) and transaortic access, outcomes were comparable between TAVR and SAVR.The first TAVR described in man by Cribier et al. was performed through the antegrade transfemoral route . Webb et al. first developed the retrograde transfemoral approach requiring a surgical cutdown . This was followed by development of the antegrade transapical approach by a German group . TA‐TAVR has been received with caution recently after increased risk of complications, longer http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Catheterization and Cardiovascular Interventions Wiley

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1522-1946
eISSN
1522-726X
D.O.I.
10.1002/ccd.27357
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONThe results of the original Placement of AoRTic TraNscathetER Valve (PARTNER) trial and the U.S CoreValve Pivotal Study demonstrated the feasibility of transcatheter aortic valve replacement (TAVR) in high‐ and prohibitive‐risk patients and have led to its widespread acceptance as an option for patients with severe aortic stenosis who could not undergo surgery, and as an acceptable alternative to surgical aortic valve replacement (SAVR) in high‐risk surgical risk patients . Recently, the PARTNER 2 trial found comparable outcomes for TAVR as compared to SAVR in intermediate‐risk patients and led to the approval of TAVR as an alternative to SAVR in intermediate‐surgical‐risk cohort . However, transfemoral TAVR (TF‐TAVR) specifically was associated with lower risks of death and disabling strokes. In the transthoracic cohort which included patients undergoing TAVR through transapical (TA‐TAVR) and transaortic access, outcomes were comparable between TAVR and SAVR.The first TAVR described in man by Cribier et al. was performed through the antegrade transfemoral route . Webb et al. first developed the retrograde transfemoral approach requiring a surgical cutdown . This was followed by development of the antegrade transapical approach by a German group . TA‐TAVR has been received with caution recently after increased risk of complications, longer

Journal

Catheterization and Cardiovascular InterventionsWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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