Percutaneous versus surgical cut-down access in transfemoral transcatheter aortic valve replacement: A meta-analysis

Tomo Ando, Alexandros Briasoulis, Anthony A. Holmes, Hisato Takagi, David P. Slovut

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: The transfemoral (TF) approach has become the preferred approach for transcatheter aortic valve replacement (TAVR) because of its low risk profile. However, the relative safety of the percutaneous approach (PC) compared to surgical cut-down (SC) remains unclear. Our aim was to compare the outcomes between PC versus SC access in patients undergoing TF-TAVR using a meta-analysis. METHODS: We conducted a systematic electronic database search for studies reporting major and minor vascular complications (VC), major and minor bleeding, and perioperative all-cause mortality, in PC versus SC TF-TAVR cases. Complications were reported based on the Valve Academic Research Consortium criteria. A random-effects model was used to calculate odds ratios and 95% confidence intervals. RESULTS: Eight observational cohort studies and one randomized control trial (2513 patients in PC and 1767 patients in SC) were included in the analysis. Major and minor VC, as well as bleeding complications, were comparable between the two approaches. The need for surgical intervention for VC was comparable between PC and SC. There was no difference in perioperative all-cause mortality. CONCLUSIONS: PC and SC have similar safety profiles and outcomes when used appropriately in selected patients.

Original languageEnglish (US)
JournalJournal of Cardiac Surgery
DOIs
StateAccepted/In press - 2016

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Meta-Analysis
Blood Vessels
Hemorrhage
Safety
Mortality
Observational Studies
Cohort Studies
Odds Ratio
Databases
Confidence Intervals
Transcatheter Aortic Valve Replacement
Research

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous versus surgical cut-down access in transfemoral transcatheter aortic valve replacement : A meta-analysis. / Ando, Tomo; Briasoulis, Alexandros; Holmes, Anthony A.; Takagi, Hisato; Slovut, David P.

In: Journal of Cardiac Surgery, 2016.

Research output: Contribution to journalArticle

Ando, Tomo ; Briasoulis, Alexandros ; Holmes, Anthony A. ; Takagi, Hisato ; Slovut, David P. / Percutaneous versus surgical cut-down access in transfemoral transcatheter aortic valve replacement : A meta-analysis. In: Journal of Cardiac Surgery. 2016.
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