Transcatheter aortic valve implantation via surgical subclavian versus direct aortic access: A United Kingdom analysis

• Published in: International journal of cardiology 2020-06, Vol.308, p.67-72
• Main Authors: Myat, Aung, Papachristofi, Olympia, Trivedi, Uday, Bapat, Vinayak, Young, Christopher, de Belder, Adam, Cockburn, James, Baumbach, Andreas, Banning, Adrian P., Blackman, Daniel J., MacCarthy, Philip, Mullen, Michael, Muir, Douglas F., Nolan, James, Zaman, Azfar, de Belder, Mark, Cox, Ian, Kovac, Jan, Brecker, Stephen, Turner, Mark, Khogali, Saib, Malik, Iqbal, Redwood, Simon, Prendergast, Bernard, Ludman, Peter, Sharples, Linda, Hildick-Smith, David
• Format: Article
• Language: English
• Subjects: Aortic stenosis; Aortic Valve - surgery; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - surgery; Axillary; Direct aortic; Humans; Subclavian; Transcatheter aortic valve implantation; Transcatheter Aortic Valve Replacement - adverse effects; Treatment Outcome; United Kingdom - epidemiology
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2020.03.059

Surgical subclavian (SC) and direct aortic (DA) access are established alternatives to the default transfemoral route for transcatheter aortic valve implantation (TAVI). We sought to find differences in survival and procedure-related outcomes after SC- versus DA-TAVI. We performed an observational cohort analysis of cases prospectively uploaded to the UK TAVI registry. To ensure the most contemporaneous comparison, the analysis focused on SC and DA procedures performed from 2013 to 2015. Between January 2013 and July 2015, 82 (37%) SC and 142 (63%) DA cases were performed that had validated 1-year life status. Multivariable regression analysis showed procedure duration was longer for SC cases (SC 193.5 ± 65.8 vs. DA 138.4 ± 57.7 min; p