The most commonly used accesses for transcatheter aortic valve implantation (TAVI) are the transfemoral (TF-TAVI) and the transapical (TA-TAVI) ones. There are concerns about TA-TAVI use in patients with reduced left ventricular ejection fraction (LVEF). The aim of this retrospective multicentre study was to compare the outcomes of TA-TAVI and TF-TAVI in patients with poor LVEF.
TAVI yields good results in patients with depressed LVEF. Age, preoperative creatinine and preoperative pacemaker are independently associated with mortality. The TA access is associated with mortality only after 3 years of follow-up, thus probably reflecting a worse general clinical status of these patients.
- D'Onofrio A, Salizzoni S, Filippini C, Agrifoglio M, Alfieri O, Chieffo A, Tarantini G, Gabbieri D, Savini C, Immè S, Ribichini F, Cugola D, Raviola E, Loi B, Pompei E, Cappai A, Cassese M, Luzi G, Aiello M, Santini F, Rinaldi M, Gerosa G. Transapical aortic valve replacement is a safe option in patients with poor left ventricular ejection fraction: results from the Italian Transcatheter Balloon-Expandable Registry (ITER). Eur J Cardiothorac Surg 2017 Jul 20. doi: 10.1093/ejcts/ezx227. [Epub ahead of print] Go to PubMed