Drafts BC, et al. - This study compared surgical cut-down (SC) vs. percutaneous (PC) approaches for transfemoral (TF)-transcatheter aortic valve replacement (TAVR) in terms of short-term (30 days) and late (12 months) vascular adverse events. Findings revealed that the PC approach versus the SC approach afforded a shorter hospital length of stay (LOS) and higher rate of direct discharge to home, with similar risk of vascular complications, late vascular adverse events, and all-cause mortality at 12 months.

Methods

• This study included a total of 146 men and women aged 79.7 ± 10.0 years with severe aortic stenosis deemed extreme or high risk for surgery underwent TF -TAVR using either SC (n= 61) or PC (n= 85) approaches.
• At an average of 12.1 months following TAVR, Valve Academic Research Consortium (VARC-2) outcomes were evaluated.

Results

• Findings demonstrated that post-TAVR, the PC group vs. the SC group had shorter hospital length of stay (LOS) (5.1 ± 3.9 vs. 8.2 ± 6.6 days; P < 0.001).
• Furthermore, direct discharge to home was seen more in the PC than the SC group (85.9% vs. 68.9%, P < 0.05).
• Researchers found that at 30 days, there were 13/61 (21.3%) and 16/85 (18.8%; P < 0.05) of any vascular events, and 2/61 (3.3%) and 2/85 (2.4%; P = 0.73) major vascular events in the SC and PC groups, respectively.
• Data reported that the SC (14/61; 23%) and PC groups [17/85 (20%); P = 0.34] did not differ in terms of all-cause mortality.
• In addition, it was noted that there was no difference in any [4/33 (12%) vs. 3/43 (7%); P = 0.84] or major vascular adverse events [1/33 (3%) vs. 1/43 (2%); P = 0.79] in subjects that underwent adjunctive endovascular intervention compared to those who did not, respectively.
• Results also revealed that when comparing SC to PC groups, no statistically significant univariate or multivariate predictors of any vascular event at 12 months were found.