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Does Tc Tavr For Delivery Of Either Balloon Expandable (be) And Self Expanding (se) Tavr Valve Equally Efficacious
Mohiuddin Cheema, Talhat Azemi, Jawad Haider, Immad Sadiq, Raymond Mckay, David Underhill.
Hartford Hospital, Hartford, CT, USA.

OBJECTIVE:
Does TC TAVR for delivery of either Balloon Expandable (BE) and Self Expanding (SE) TAVR valve equally efficacious
METHODS:
A retrospective analysis of consecutive Transcarotid TAVR procedures performed at a single tertiary care medical center between 2016 and 2020 utilizing both valves. All outcomes are reported in accordance with VARC definitions.
RESULTS:
Total of 92 patients were included in the study: 56 patients received BE and 36 received SE TC TAVR. Both Groups were comparable for comorbidities and STS PROM. TC BE TAVR group had slightly higher previous MI (41% vs 17% p=0.014) Anesth was GA in 98% BE vs 97% in SE Group. OR time was equivalent. There was a significant difference in Contrast Volume (71 cc vs 95 cc p=0.009) and Fluoro time (min) 18.6 vs 24.7 p <0.009 for BE vs SE respectively. The total radiation dose (Kerma) was higher in SE group 804.56 vs BE 536.68 p <0.06. There were no differences in bleeding events (BE 5% vs SE 6%, p=0.15), Perioperative Stroke (BE 4% vs SE 6%, p=0.60), Vascular complications (BE 9% vs SE 6%, p=0.55), Unplanned Cardiac Surgery (BE 2% vs SE 3% p= 0.75) or need for PPM (BE 9% vs SE 11%, p=0.71). There were no differences in perioperative mortality (BE 0.0% vs SE 0.0%), ICU stay and hospital LOS (BE 3.5 days vs SE 3.8 days p=0.6). 30 Day Mean gradients (mm HG) were lower in SE group (7.6 vs 10.7 p=0.001) and there was higher 30 day mild PVL with SE vs BE group (50% vs 17% p=0.001) but this was reduced to 33% vs 13% by 1 year.
CONCLUSIONS:
Transcarotid approach to TAVR is safe and efficacious and can provides excellent outcomes utilizing both TAVR valve platforms. There is less use of contrast or radiation with BE valves.


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