Unilateral access versus bilateral access in transfemoral transcatheter aortic valve replacement: A systematic review and meta-analysis.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian heart journal Pub Date : 2025-06-04 DOI:10.1016/j.ihj.2025.06.001

Hritvik Jain, Mariam Shahabi, Aimen Shafiq, Siddharth P Agrawal, Marwan S Saad, Barry L Sharaf, Paul C Gordon, J Dawn Abbott, Saraschandra Vallabhajosyula

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引用次数: 0

Abstract

Background: Transcatheter aortic valve replacement (TAVR) procedures frequently require a second arterial access to perform aortic root angiography. In recent times, there has been an increase in the use of unilateral access, however, the outcomes data are conflicting.

Methods: A systematic database search was conducted to retrieve studies comparing unilateral to bilateral access in TAVR. Risk ratios (RR) with 95 % confidence intervals (CI) were pooled using the Mantel-Haenszel random-effects model. Outcomes of interest included minor vascular complications, major vascular complications, 30-day stroke, and 30-day all-cause mortality.

Results: Three studies with a total of 2,181 patients undergoing TAVR (unilateral 368, bilateral 1813) were included in this meta-analysis. Unilateral access was comparable to bilateral access for minor vascular complications (RR: 0.88; 95 % CI: 0.48-1.62), major vascular complications (RR: 0.61, 95 % CI: 0.14-2.75), stroke (RR: 0.95; 95 % CI: 0.42, 2.17) and all-cause mortality (RR: 0.52; 95 % CI: 0.04, 6.93).

Conclusion: Unilateral access for TAVR was associated with similar short-term outcomes and safety profiles compared to bilateral access for TAVR.

查看原文本刊更多论文

经股动脉导管主动脉瓣置换术的单侧通道与双侧通道：系统回顾和meta分析。

背景：经导管主动脉瓣置换术（TAVR）通常需要第二动脉通道进行主动脉根部血管造影。近年来，单边准入的使用有所增加，然而，结果数据相互矛盾。方法：系统检索数据库，检索TAVR单侧与双侧通路的比较研究。使用Mantel-Haenszel随机效应模型合并95%置信区间的风险比（RR）。研究结果包括轻微血管并发症、主要血管并发症、30天卒中和30天全因死亡率。结果：三项研究共2181例患者接受TAVR（单侧368例，双侧1813例）纳入本荟萃分析。单侧入路与双侧入路治疗轻微血管并发症相当(RR: 0.88；95% CI: 0.48-1.62)，主要血管并发症（RR: 0.61, 95% CI: 0.14-2.75），卒中(RR: 0.95；95% CI: 0.42, 2.17)和全因死亡率(RR: 0.52；95% ci: 0.04, 6.93)。结论：与双侧TAVR通路相比，单侧TAVR通路具有相似的短期预后和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

52 days

期刊介绍： Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.