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Updated: Jun 12, 2025
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Unilateral access versus bilateral access in transfemoral transcatheter aortic valve replacement: A systematic review
Hritvik Jain1, Mariam Shahabi2, Aimen Shafiq2
1Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, India.
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.
