Feasibility and safety of transcaval transcatheter aortic valve implantation: A multicentre European registry
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Aims: A transfemoral transarterial approach is considered the preferable access route for transcatheter aortic valve implantation (TAVI), followed by a transaxillary/subclavian TAVI approach. However, these approaches may not be an option in all patients. This study aimed to report the initial European experience with transfemoral transcaval TAVI. Methods and results: Data on 50 patients treated by transcaval TAVI in five European centres were collected and analysed according to the Valve Academic Research Consortium (VARC)-2 definitions. The study population had a mean age of 78.7±8.0 years and a high surgical risk profile (median STS risk score 6.1%, interquartile range 3.0-11.2%). Transcaval access was successful in 49 out of 50 patients and device success was obtained in 94% of cases. Closure of the caval-aortic puncture site with a nitinol cardiac occluder was successful in all cases without need for emergent surgery. One patient received additional sealing of the aortic puncture site with a covered stent one day post TAVI due to a gradual haemoglobin drop of 3 g/dL. VARC-2-defined life-threatening bleeding and major vascular complications possibly related to transcaval access were 4% and 10%, respectively. There were no bleeding or vascular complications after discharge. At 30 days, the clinical efficacy endpoint was reached in 88% of patients. Conclusions: Transfemoral transcaval access proved to be a feasible and safe TAVI approach for highrisk patients with severe aortic stenosis not suitable for transfemoral or transaxillary/subclavian transarterial access.
Originalsprog | Engelsk |
---|---|
Tidsskrift | EuroIntervention |
Vol/bind | 15 |
Udgave nummer | 15 |
Sider (fra-til) | E1319-E1324 |
ISSN | 1774-024X |
DOI | |
Status | Udgivet - 2020 |
ID: 250168445