Valvular & structural heart disease
Single- Versus Dual-Access Transcatheter Aortic Valve Implantation Using Balloon-Expandable Platform: A Propensity Score Matching Study
Authors' conclusion
SA is a feasible and safe strategy compared to DA TAVI. It was associated with quicker procedure times, lower contrast and radiation exposure, and a better 30-day safety profile than the DA strategy. Future randomized studies are needed to further assess this strategy.
Study context
- Population
- Consecutive patients who underwent transfemoral transcatheter aortic valve implantation (TAVI) using balloon-expandable valve Sapien 3 Ultrapatients who had transfemoral TAVI, 117 (22%) underwent single access (SA), matched cohort 204 patients (102 in each group)
- Participants
- 532 patients
- Exposure
- SA vs dual access (DA) TAVI
- SAn = 102
- DAn = 102reference
- Outcome
- Co-primary endpoints: device success and 30-day safety endpoints (Valve Academic Research Consortium 3)
- Follow-up
- 30 days
Methodological detailspropensity score matching with a 1:1 ratio, data prospectively entered into a dedicated web-based database
- Propensity score matching with a 1:1 ratio
- Data prospectively entered into a dedicated web-based database
Main finding
As reported in the abstract
SA
- Device success
- 3.9%
- 30-day safety profile
- 15.0%
DA
- Device success
- 3.9%
- 30-day safety profile
- 28.9%
Device success
SA3.9%
DA3.9%
30-day safety profile
SA15.0%
DA28.9%
SA vs DAOdds ratio (95% CI)P value
Device success
1.00(0.24–4.11)
P > 0.9930-day safety profile
0.44(0.22–0.88)
P = 0.02Observational data: associations, not effects.
Further findings
- SA was associated with a significant reduction in contrast use, fluoroscopy time, radiation exposure, and total procedure time
Original publication
Single- Versus Dual-Access Transcatheter Aortic Valve Implantation Using Balloon-Expandable Platform: A Propensity Score Matching Study. JACC Adv. Published 21 August 2025. doi:10.
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