A Meta-analysis On Efficacy Of Transfemoral Vursus Transapical Aortic Valve Implantation In Patients With Severe Aortic Stenosis

Objective The efficacy and safety of transfemoral vursus transapicalaortic valve implantation in patients with severe aortic stenosis wasanalyzed in this Meta-analysis.Method We search the foreign major electronic databases（Pubmed、Medline、The Cochrance Library、Embase）with eligible published clinicalnon-randomized studies of evaluating the effects of transfemoral versustransapical in patients with severe aortic stenosis. After evaluating theclinical research according to the eligibility criteria, we got proceduresuccess, mortality and other information in both groups. Finally we usedthe meta-analysis of the data gathering from the studies by the software ofreview manager5.1.Result According to the eligibility criteria,7clinicalnon-randomized studies with2404patients (transfemoral aortic valveimplantation, n=1274, transapical aortic valve implantation, n=1130) wereincluded in final analysis. Data of meta-analysis shows: Rate of procedure success in the two groups has not significant difference.(OR=0.94，95%CI[0.65～1.35]，P=0.72). The mortality of30days in transfemoralaortic valve implantation group are lower than that of transapical aorticvalve implantation (OR=0.67，95%CI[0.49～0.91]，P=0.01), this was moreobvious in1-year outcomes (OR=0.75，95%CI[0.61～0.93]，P=0.008).Conclusion Comparing with transapical aortic valve implantation，transfemoral aortic valve implantation in patients with severe aorticstenosis has benefits in:1) not reducing the rate of procedure success;2)reducing the short-term(30days), especially long-term(1year) mortality inthe patients with severe aortic stenosis.