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Learning Alternative Access Approaches for Transcatheter Aortic Valve Replacement: Implications for New Transcatheter Aortic Valve Replacement Centers 

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Presentation on theme: "Learning Alternative Access Approaches for Transcatheter Aortic Valve Replacement: Implications for New Transcatheter Aortic Valve Replacement Centers "— Presentation transcript:

1 Learning Alternative Access Approaches for Transcatheter Aortic Valve Replacement: Implications for New Transcatheter Aortic Valve Replacement Centers  Matthew C. Henn, MD, Thomas Percival, MD, Alan Zajarias, MD, Spencer J. Melby, MD, Brian R. Lindman, MD, Nishath Quader, MD, Ralph J. Damiano, MD, Marc R. Moon, MD, John M. Lasala, MD, Ravinder S. Rao, MD, Jennifer Bell, BSN, Marci S. Damiano, RN, Hersh S. Maniar, MD  The Annals of Thoracic Surgery  Volume 103, Issue 5, Pages (May 2017) DOI: /j.athoracsur Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Access approach—transfemoral (blue bars), transapical (red bars), or transaortic (green bars)—by year. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Learning curve metrics: (A) procedure time; (B) fluoroscopy (Fluoro) time; and (C) contrast dose. Blue lines indicate transfemoral approach; red lines, transapical; and green lines, transaortic. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Kaplan-Meier estimates of survival comparing survival of cases performed before proficiency, namely, cases 1 to 50 (green lines) versus those performed after proficiency was reached: (A) transfemoral transcatheter aortic valve replacement (TAVR [blue line = cases 51 to 179]); (B) transapical TAVR (blue line = cases 51 to 120); and (C) transaortic TAVR (blue line = cases 51 to 101). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Kaplan-Meier estimates of overall survival of all three transcatheter aortic valve replacement (TAVR) access approaches combined, comparing before proficiency (cases 1 to 50 [green line]) to after proficiency (cases 51 to present [blue line]). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

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