Abstract 20031: Transcatheter Aortic Valve Replacement Using Transfemoral vs Transapical Approach: A comprehensive Meta-analysis Comparing 30-day & 1-year Cerebrovascular Event Rates

Abstract

Background: Transcatheter Aortic valve replacement (TAVR) has emerged as new technique for the management of patient with severe Aortic Stenosis (AS). Stroke is a potential complication associated with the procedure, when performed via both transfemoral (TF) and transapical approach (TA). Due to limited data, we performed a comprehensive meta-analysis comparing 30-day and 1-year stroke rates with TAVR performed using TF vs TA approach. Methods: We searched SCOPUS since inception to July 2014 using pre-defined criteria. The cerebrovascular event rates and type were estimated at different time points using standard random effects model. Results: 5 studies, with total 1956 valves placed, reported 30-day stroke rates with TA approach, and 9 studies, with 1146 valves, reported stroke rates with TF approach. No significant difference (p=0.313) was noted with TA vs TF approach with stroke rates 1.74 (0.61-2.87), 1.52 (0.71-2.33) respectively (Figure 1, Panel A). Similarly, 4 studies, with total 1657 valves, reported 1-year stroke rates with TA approach, and 8 studies, with 1034 valves, reported stroke using TF approach. Again, no significant difference (p=0.161) was noted with TA vs TF approach with adjusted stroke rates 3.78 (1.72-5.85), 3.11 (1.49-4.74) respectively (Figure 1, Panel B). Conclusion: We did not observe any difference in stroke rates when TAVR is performed using transapical versus transfemoral approach.