C-2 | TAVR Outcomes in Systemic Lupus Erythematosus: Accelerated Valve Deterioration at Mid-Term Follow-Up

Background: While the transfemoral (TF) approach is the standard access route for transcatheter aortic valve replacement (TAVR), the optimal alternative access strategy remains uncertain.The transaxillary (TAx) approach has emerged as a promising option.Accordingly, we conducted a meta-analysis of propensity-score-matched (PSM) studies comparing TAx and TF approaches to minimize confounding and selection bias.Methods: We conducted a systematic search across databases to find PSM comparing TAx-TAVR and TF-TAVR.We pooled the outcomes using adjusted odds ratio (aOR), and 95% confidence intervals (Cis) using a random-effects model.Results: A total of six matched studies were included.Pooled analysis showed that incidence of myocardial infarction was significantly increased in TAx-TAVR (aOR: 2.18; 95% CI: 1.01 -4.71; p = 0.048) as compared to TF-TAVR.The incidence of all-cause and cardiovascular mortality, acute kidney injury, stroke, pacemaker implantation, any aortic regurgitation, any bleeding and vascular complications was comparbale between the two groups.Conclusions: These findings suggest broadly similar safety profiles, with a potential signal for increased myocardial infarction risk with TAx-TAVR.However, adequately powered randomized controlled trials with longer follow-up are needed to establish causality and confirm the durability of these findings.