Extremity Function After Transfemoral Transcatheter Aortic Valve Implantation: A TAVI XS Sub-Study

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• Physical decline post-transcatheter aortic valve implantation (TAVI) is linked to adverse outcomes.
• Limited data exist on extremity function following TAVI.
• This study investigated extremity function and decline after transfemoral TAVI.

Purpose of the Study:

• Assess extremity function after transfemoral TAVI.
• Evaluate the incidence and predictors of functional decline.
• Compare outcomes between upper- and lower-extremity secondary access routes.

Main Methods:

• A sub-study of the TAVI XS randomized clinical trial.
• Compared upper- and lower-extremity secondary access during TAVI.
• Assessed extremity function at baseline and 30 days using validated scales.

Main Results:

• Both lower-extremity and upper-extremity function improved significantly post-TAVI.
• The incidence of clinically relevant decline was low (8.4% lower, 8.0% upper).
• No significant differences in post-TAVI function were found between access groups; predictors of decline included antithrombotic therapy and multiple punctures.

Conclusions:

• Clinically relevant decline in extremity function after TAVI is infrequent.
• Upper- and lower-extremity secondary access approaches yield similar functional outcomes.
• Baseline antithrombotic therapy and multiple punctures are associated with functional decline.