ArticleClinical research in cardiology : official journal of the German Cardiac Society2013
The groin first approach for transcatheter aortic valve implantation: are we pushing the limits for transapical implantation?
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
- Impact of left ventricular conduction defect with or without need for permanent right ventricular pacing on functional and clinical recovery after TAVR.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Trial
- Feasibility of sheathless transfemoral aortic valve implantation in patients with small access vessel diameters.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Trial
- Declining Trend of Transapical Access for Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis.Journal of interventional cardiology · 2022Article
- Paravertebral analgesia in transapical transcatheter aortic valve replacement.Heart, lung and vessels · 2015Article
- Paravertebral analgesia in transapical transcatheter aortic valve replacement.Heart, lung and vessels · 2015Article
- Transapical access for catheter ablation of left ventricular tachycardia in a patient with mechanical aortic and mitral valve prosthesis.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Worldwide TAVI registries: what have we learned?Clinical research in cardiology : official journal of the German Cardiac Society · 2014Review
- Hotline update of clinical trials and registries presented at the American College of Cardiology Congress 2014.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Transcatheter aortic valve implantation in patients with severely reduced left ventricular systolic function: a single-center experience.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Sleep-disordered breathing in patients undergoing transfemoral aortic valve implantation for severe aortic stenosis.Clinical research in cardiology : official journal of the German Cardiac Society · 2013Article
- The revised EuroSCORE II for the prediction of mortality in patients undergoing transcatheter aortic valve implantation.Clinical research in cardiology : official journal of the German Cardiac Society · 2013Article
- Safety and efficacy of the subclavian access route for TAVI in cases of missing transfemoral access.Clinical research in cardiology : official journal of the German Cardiac Society · 2013Article
- Transapical aortic valve implantation - What have we learnt? Quo vadis?Cardiovascular diagnosis and therapy · 2012Article
- Learning experience with transapical aortic valve implantation - the initial series from Leipzig.Cardiovascular diagnosis and therapy · 2012Article
- Chronic postthoracotomy pain in transapical transcatheter aortic valve replacement.Annals of cardiac anaesthesiaObservational
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTranscatheter aortic valve implantation (TAVI) is a therapeutic option for old and multimorbid patients with severe aortic stenosis. When applying the groin first approach by transfemoral implantation, patients in the transapical group are highly selected with even higher morbidity. We report outcome of the transapical group.
methodsBetween April 2008 and May 2011, 267 patients underwent TAVI through either a transfemoral (n = 201 CoreValve, n = 33 Edwards Sapien prostheses; mean age 81 ± 6 years, logistic EuroSCORE 19.5 ± 12.6 %; 4-76, STS score 7.2 ± 4 %; 1.5-28.9) or transapical approach (n = 33 Edwards Sapien prostheses; mean age 80 ± 1 years, logistic EuroSCORE 31.6 ± 17.1 %; 9.4-69.1, STS score 12.8 ± 7.1 %; 2.5-28.8). The transapical access was chosen only when transfemoral implantation was not possible.
resultsEuroSCORE and STS score were significantly higher in the transapical group (p = 0.001, respectively). A 30-day survival was comparable with 87.9 % in the transapical versus 92 % in the transfemoral group (p = 0.52). In the transapical group, female gender was predominant (n = 23; 70 %). Eight patients underwent previous cardiac surgery. All transapical implantations were successful. No bleeding or neurological complications occurred. Six patients required postoperative pacemaker implantation. Cardiac decompensation with concomitant pneumonia was the underlying cause for early mortality, except for one patient with abdominal malperfusion. Follow-up (0-37 months) was complete in 100 %, nine patients died after 30 days postoperatively (6 cardiac and 3 non-cardiac related). Echocardiography revealed good valve function with not more than mild paravalvular incompetence.
conclusionsGroin first approach is reasonable due to less invasive implantation technique. However, despite even higher predicted mortality, transapical aortic valve implantation is non-inferior to transfemoral approach.
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