{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:56:20Z","timestamp":1788540980822,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T00:00:00Z","timestamp":1422921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated the long\u2010term safety, efficacy and clinical outcomes associated with transaortic (TAO) transcatheter aortic valve replacement (TAVR) in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>We previously reported the technical feasibility and short\u2010term safety of TAO TAVR. Compared to transapical (TAP) access, the TAO approach was associated with shorter median intensive care unit (ICU) length of stay (LOS) and more favorable technical learning curve. However, outcomes data beyond 30 days were lacking and the longer\u2010term clinical consequences of this strategy were unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mortality outcomes at 1 year (and longer) of 44 consecutive patients who underwent TAO TAVR in our institution were compared with that of 76 consecutive patients who underwent TAP TAVR at our site. Risk\u2010adjusted analysis was performed in propensity\u2010matched patients (25 from each group) to account for baseline differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TAO TAVR was associated with a trend towards lower all\u2010cause mortality at 1 year compared to TAP TAVR (18% vs. 34%, P=0.09 in the overall sample; 12% vs. 40%, <jats:italic>P<\/jats:italic>\u2009=\u20090.05 in the matched cohort). The higher probability of survival with TAO TAVR persisted after a median follow\u2010up period of 23 months (hazard ratio [HR]=1.96, <jats:italic>P<\/jats:italic>\u2009=\u20090.06 in the overall sample; HR\u2009=\u20093.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.01 in the matched cohort). Cardiovascular mortality at 1 year was lower with TAO TAVR (2% vs. 22%, <jats:italic>P<\/jats:italic>\u2009=\u20090.01 in the overall sample; 4% vs. 28%, <jats:italic>P<\/jats:italic>\u2009=\u20090.05 in the matched cohort). ICU LOS (shorter in the TAO group) and implantation of second prosthetic valve (higher incidence in the TAP group) were independent predictors of long\u2010term mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The outcomes associated with TAO TAVR compare favorably with TAP TAVR. Our results appear to corroborate the long\u2010term safety and efficacy of the TAO approach in TAVR patients with inadequate iliofemoral access. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25785","type":"journal-article","created":{"date-parts":[[2014,12,15]],"date-time":"2014-12-15T15:27:56Z","timestamp":1418657276000},"page":"1226-1230","source":"Crossref","is-referenced-by-count":20,"title":["Long\u2010term outcomes associated with the transaortic approach to transcatheter Aortic valve replacement"],"prefix":"10.1002","volume":"85","author":[{"given":"Joel A.","family":"Lardizabal","sequence":"first","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conrad J.","family":"Macon","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harit","family":"Desai","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Singh","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A.","family":"Martinez","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Alfonso","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio G.","family":"Cohen","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan W.","family":"Heldman","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald B.","family":"Williams","sequence":"additional","affiliation":[{"name":"The Multi\u2010Disciplinary Structural Heart Disease Program of the University of Miami \u2013 Miller School of Medicine Miami FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.076"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.03.009"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25036"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.282043"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1114705"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.050"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.09.088"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1008232"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.10.024"}],"container-title":["Catheterization 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