Computed tomography guided tailored approach to transfemoral access in patients undergoing transcatheter aortic valve implantation

Abstract

Background: Transfemoral approach (TFA) is the most common access route for transcatheter aortic valve implantation (TAVI). Percutaneous femoral access (PA) is preferred over the surgical approach (SA), however, may be associated with a higher risk of access site complications. Thus, we aimed to assess outcomes of computed tomography-guided tailored approach to percutaneous and surgical TFA in patients undergoing TAVI. Methods:We evaluated data of 158 patients, who underwent TAVI via femoral route between January 2017 and December 2018. In the PA group, vascular closure was performed with the use of two percutaneous suture devices and an additional mechanical seal device. We compared complications rate and outcomes. Results:Of the 158 patients (92%; mean age 79.6 years, 60.8% female), in 92 (61%) patients PA was performed and in 66 (39%) patients SA was used. Median (IQR) radiation exposure as well as contrast volume dose was higher in the PA group compared to the SA group 614.0

Hybrid method of large bore arterial access closure: Single-center initial experience based on percutaneous coronary artery interventions assisted with left ventricle support device

“…Overall efficacy of the vascular closure in the presented series was 90.4%, which was comparable to the data reported by other authors. In the literature, the success rate varies from 91.4% to 100% [ 4 – 8 ]. Nonetheless, Toggwailer et al [ 9 ] described the necessity of additional surgery in almost 28% of early patients due to vascular complications, with an impressive reduction to 2% at the end of the study.…”