?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Approaches+for+Transcatheter+Aortic+Valve+Replacement%3A+A+Systematic+Review+and+Meta-Analysis&rft.creator=Nagaraja%2C+V&rft.creator=Raval%2C+J&rft.creator=Eslick%2C+GD&rft.creator=Denniss%2C+AR&rft.subject=Online+Journal+of+Health+and+Allied+Sciences&rft.description=Introduction%3A+Retrograde+transfemoral+and+antegrade+transapical+approaches+are+mostly+used+for+transcatheter+aortic+valve+replacement.+This+meta-analysis+is+designed+to+assess+the+performance+of+the+transfemoral+and+transapical+approach.+Methods%3A+A+systematic+search+was+conducted+using+MEDLINE%2C+PubMed%2C+EMBASE%2C+Current+Contents+Connect%2C+Cochrane+library%2C+Google+Scholar%2C+Science+Direct%2C+and+Web+of+Science.+Original+data+was+abstracted+from+each+study+and+used+to+calculate+a+pooled+odd+ratio+(OR)+and+95%25+confidence+interval+(95%25+CI).+Results%3A+Only+14+studies+comprising+of+6965+patients+met+full+criteria+for+analysis.+The+mean+duration+of+hospitalisation+and+procedure+duration+were+similar+among+the+2+cohorts.+The+30+days+mortality+(OR%3A+0.70%2C+95%25+CI%3A+0.531-0.921)%2C+the+need+for+haemodialysis+(OR%3A+0.29%2C+95%25+CI%3A+0.157-0.525)+and+one+year+mortality+(OR%3A+0.72%2C+95%25+CI%3A+0.564-0.927)+were+lower+in+the+transfemoral+cohort.+The+frequency+of+stroke+at+30+days+and+new+pacemaker+insertion+were+comparable.+However%2C+the+prevalence+of+vascular+complication+(OR%3A+2.88%2C+95%25+CI%3A+1.821-4.563)+was+higher+in+the+transfemoral+group.+The+incidence+of+aortic+regurgitation+(OR%3A+1.25%2C+95%25+CI%3A+0.844-1.855)%2C+valve+embolization+(OR%3A+2.00%2C+95%25+CI%3A+0.622-6.448)%2C+major+bleeding+incidence+rates+(OR%3A0.77%2C+95%25+CI%3A+0.488-1.225)%2C+coronary+obstruction+(OR%3A0.74%2C+95%25+CI%3A0.234-2.311)%2C+myocardial+infarction+(OR%3A+0.75%2C+95%25+CI%3A+0.28-2.00)%2C+conversion+to+open+cardiac+surgery+(OR%3A+0.29%2C+95%25+CI%3A+0.062-1.343)+and+successful+implantation+(OR%3A+0.67%2C+95%25+CI%3A+0.394-1.149)+were+comparable+in+the+two+cohorts.+Conclusions%3A+In+the+absence+of+a+randomized+controlled+study%2C+the+ability+to+discriminate+true+differences+is+challenging.+Even+though+the+complications+rate+was+much+lower+in+transfemoral+group+as+compared+to+transapical+group%2C+the+current+literature+does+not+support+a+clear+superiority+of+one+approach+to+TAVR+over+the+other.&rft.publisher=Kakkilaya+BS&rft.contributor=Kakkilaya%2C+Dr+Srinivas&rft.date=2014-02-20&rft.type=Journal+(On-line%2FUnpaginated)&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F9710%2F1%2F2013-4-3.pdf&rft.identifier=++Nagaraja%2C+V+and+Raval%2C+J+and+Eslick%2C+GD+and+Denniss%2C+AR++(2014)+Approaches+for+Transcatheter+Aortic+Valve+Replacement%3A+A+Systematic+Review+and+Meta-Analysis.++%5BJournal+(On-line%2FUnpaginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F9710%2F