ArticleScientific reports2025
In-hospital outcomes of non-elective transapical transcatheter versus surgical aortic valve replacement.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
When transfemoral (TF) access is not available during transcatheter aortic valve replacement (TAVR), transapical (TA)-TAVR can be performed. However, TA-TAVR is associated with significantly higher risk, and it is unclear whether it provides more benefit than surgical aortic valve replacement (SAVR) in non-elective cases. This study aimed to compare the in-hospital outcomes of non-elective TA-TAVR and SAVR by conducting a population-based analysis using a national registry. Patients who underwent non-elective TA-TAVR and SAVR were selected from National Inpatient Sample from Q4 2015 to 2021. Exclusion criteria included age < 18 years and concomitant procedures. Demographics, socioeconomic status, comorbidities, relevant diagnosis, transfer-in status, and hospital characteristics were matched between patients who underwent TA-TAVR and SAVR using a 1:3 propensity-score matching. In-hospital outcomes were compared. There were 130 and 10,487 patients who underwent TA-TAVR and SAVR, respectively. After the propensity-score matching, all TA-TAVR patients were matched to 341 SAVR patients. TA-TAVR and SAVR patients had comparable in-hospital mortality (7.69% vs. 7.33%, p = 0.85), myocardial infarction (3.85% vs. 4.4%, p = 1.00), stroke (0.77% vs. 1.76%, p = 0.69), respiratory complications (15.38% vs. 17.6%, p = 0.68), cardiogenic shock (14.62% vs. 12.61%, p = 0.55), and pacemaker implantation (10% vs. 7.33%, p = 0.35). However, TA-TAVR patients had lower hemorrhage/hematoma (38.46% vs. 68.33%, p < 0.01), lower transfer out rate (33.08% vs. 44.87%, p = 0.02), and shorter length of stay (p = 0.04). All other in-hospital outcomes were comparable. Among eligible TAVR candidates in non-elective cases and when TF access is not available, both TA-TAVR and SAVR may be equally alternative approaches considering their comparable in-hospital outcomes. Further studies should compare the long-term outcomes between TA-TAVR and SAVR.
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