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Table 5 Procedural outcomes by access route

From: Balloon-expandable transcatheter aortic valve implantation with or without pre-dilation – results of a meta-analysis of 3 multicenter registries

 

TF access

TA access

TAo access

Xw/Xwo

p-value

Xw/Xwo

p-value

Xw/Xwo

p-value

 Valve size

 

0.038

 

0.005

 

0.001

  20–23 mm

37.5 / 31.4

 

29.5 / 30.7

 

26.6 / 30.8

 

  26 mm

23.2 / 39.3

 

49.2 / 40.9

 

49.5 / 44.9

 

  29 mm

39.3 / 29.3

 

21.3 / 28.5

 

23.9 / 24.4

 

 Quantity contrast agent used (mL)

131 / 120

0.240

85 / 80

0.681

94 / 80

0.008

 Effective orifice area post-surgery

1.40 / 1.65

0.203

2.10 / 2.00

0.222

1.80 / 1.82

0.809

 Indexed effective orifice area

0.71 / 0.87

0.175

1.17 / 1.04

0.137

1.04 / 1.00

0.857

 AV mean PG post-surgery

12 / 11

0.138

4 / 5

0.641

9 / 10

0.863

 Paravalvular regurgitation

 

0.001

 

< 0.001

 

< 0.001

  None/trace

85.7 / 86.0

 

78.7 / 84.7

 

76.6 / 80.8

 

  Mild

14.3 / 13.2

 

21.3 / 14.6

 

19.4 / 19.2

 

  Moderate

0 / 0.7

 

0 / 0.7

 

3.6 / 0

 

  Severe

0 / 0

 

0 / 0

 

0.5 / 0

 
 

TF access

TA access

TAo access

Xw/Xwo

OR (95% CI)

Xw/Xwo

OR (95% CI)

Xw/Xwo

OR (95%CI)

 Post-delivery balloon dilation (%)

30.4 / 15.7

0.43 (0.21–0.89)

14.8 / 9.5

1.65 (0.65–4.07)

22.5 / 25.6

0.84 (0.47–1.56)

 Access complications (%)

0 / 5

n.a.

0 / 0.7

n.a.

1.4 / 0

n.a.

 Hemodynamic instability (%)

3.6 / 0.7

0.19 (0.01–2.07)

6.6 / 4.4

0.65 (0.18–2.63)

n.c.

n.a.

 Catecholamine use (%)

1.8 / 0.7

0.4 (0.02–10.12)

32.8 / 17.5

0.44 (0.22–0.87)

n.c.

n.a.

 Device success (%)

92.9 / 98.6

5.31 (1.01–39.12)

100 / 100

n.a.

98.6 / 98.7

0.95 (0.05–7.53)

 Second valve needed (%)

0 / 0.7

n.a.

0 / 0

n.a.

1.8 / 2.6

0.7 (0.13–5.1)

 Conversion to surgery (%)

0 / 2.9

n.a.

0 / 1.5

n.a.

1.7 / 0

n.a.

 Device malfunction (%)

0 / 0

n.a.

0 / 0.7

n.a.

0.9 / 0

n.a.

 Atrioventricular block (%)

3.6 / 2.1

0.59 (0.1–4.58)

1.6 / 1.5

0.89 (0.08–19.34)

5 / 0

n.a.

 Aortic root rupture (%)

0 / 0

n.a.

0 / 0

n.a.

0.5 / 0.0

n.a.

 Correct positioning of a single prosthetic valve into the proper anatomical location (%)

100 / 100

n.a.

100 / 100

n.a.

98.6 / 98.7

1.05(0.13–21.5)

 Intended performance of the prosthetic valve (%)

92.9 / 98.6

5.31 (1.01–39.1)

100 / 100

n.a.

99.1 / 98.7

0.7 (0.07–15.2)

  1. Values are median (interquartile range) unless indicated otherwise
  2. AV Aortic valve, CI Confidence interval, n.a. Not applicable (e.g. no ratio), n.c. Data not collected, OR Odds ratio, PG Pressure gradient, TA Transapical, TAo Transaortic, TF Transfemoral, Xw Transcatheter aortic valve implantation with balloon aortic valvuloplasty, Xwo = TAVI Transcatheter aortic valve implantation without balloon aortic valvuloplasty