Abstract 14776: The Impact of Access Site on Post-Transcatheter Aortic Valve Replacement Aortic Regurgitation
Introduction: Post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) was previously associated with increased long-term mortality; however, the association between access site and outcome is less clear. This study aims to explore differences in post-procedural AR between patients undergoing TAVR via the transfemoral (TF) versus trans-apical (TA) approach.
Methods: Out of 355 patients undergoing TAVR, 95 patients (26.7%) underwent TAVR via TA access while the TF approach was used in 260(73.3%) patients. A comparison of post-procedural AR was performed as was the effect of significant AR (>mild) on outcome.
Results: Baseline characteristics were mostly similar save for a higher incidence of peripheral vascular disease in TA patients (57.8% vs. 29.8%; p <0.001) and higher STS score in TA patients (11.54±4.49 vs. 9.91±4.51; p=0.003). Patients undergoing TA access were less likely to have post-procedural AR. When post-procedural AR did develop there were no differences noted in the rates of AR severity between TA and TF. (Figure) Mortality rates at 30 days and at 1 year were higher in the TA group (16.8% vs. 5.4% (p <0.001); 27.4% vs. 17.7% (p=0.045), respectively.
Conclusions: TA access is associated with lower rate of post-procedural AR when compared to TF access, but this does not translate into a reduction in mortality.
- © 2013 by American Heart Association, Inc.