Vascular access site complications after transfemoral transcatheter aortic valve implantation in the POL-TAVI Registry: surgical versus percutaneous approach

Walas, Ryszard; Kukulski, Leszek; Rychter, J; Jaźwiec, Tomasz; Gąska, Mateusz; Hawranek, Michał; Zembala, Marian; Gąsior, Mariusz; Zembala, Michał

doi:10.23736/s0021-9509.19.11087-7

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…Moreover, observations herein, support the idea of teamwork between interventional cardiologist and cardiac surgeon and their consensus about the type of vascular access tailored by the CT assessment. However, the present results are contrary to the findings by Walas et al [ 16 ], who compared vascular access site complications between the two approaches in a large group of patients and reported higher risks of all vascular complications in the PA group and highlighting SA as a safer option. On the other hand, the patients included in the two arms of that study were not identical in terms of body mass index (BMI) and comorbidities, which may have strongly affected the results.…”

Section: Discussioncontrasting

confidence: 99%

“…Transcatheter aortic valve implantation via transfemoral approach is an established valuable treatment option for high-risk surgical patients; however, bleeding related to the smaller sheath size and other vascular complications remain relevant concerns [9,12]. Furthermore, those complications have been reported to be quite frequent and may be associated with poor clinical outcomes, such as increased morbidity in the form of acute kidney injury and increased mortality [9,16]. The present study showed that the most common complications in the transfemoral approach for TAVI were bleeding events related to vascular access, with similar rates in both study groups, despite PA group being less frail, what impact outcomes crucially [17].…”

Section: Discussionmentioning

confidence: 99%

“…Baseline clinical and echocardiographic characteristics, together with frailty evaluation by the Canadian Study of Health and Aging scale (CSHA) and procedural data were assessed [ 15 ]. Peri- and postprocedural complications, including bleeding, were assessed according to The Valve Academic Research Consortium endpoint definitions (VARC-2) criteria [ 16 ]. Finally, clinical outcomes at 30 days were assessed.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2023

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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

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

et al. 2023

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“…Furthermore, in the population included in our study, the vascular access was established surgically in almost twice as many women as in men. It appears that the more minimalistic approach to TAVI, with the utilization of percutaneous femoral access, is associated with fewer vascular complications and lower incidence of bleeding, although the results of the recent Polish analysis from the POL-TAVI registry are in discordance with these results, with a significantly higher incidence of vascular complications in patients in whom percutaneous femoral access was performed [ 30 , 31 ]. Hence, the other previously determined factors, such as more severe ilio-femoral calcification and tortuosity, lower platelet activity, or other patient- or procedure-related factors, could play a role in higher incidence of bleeding complications in women [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Female gender and the clinical and periprocedural profile and clinical outcomes of transcatheter aortic valve implantation: experiences of a tertiary Polish centre

Wilczek

Chodór

Dyrbuś

et al. 2020

pwki

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Introduction Despite the establishment of multiple factors influencing short- and mid-term outcomes in patients treated with transcatheter aortic valve implantation (TAVI), the real-world data on the association between gender and outcomes after TAVI remain conflicting. Aim To evaluate the association of female gender with the clinical and periprocedural characteristics along with in-hospital, short- and medium-term outcomes of patients treated with TAVI in comparison with male patients. Material and methods Data from the prospective, single-centre registry of consecutive patients with severe AS referred for TAVI from 26 November 2008 to 31 December 2018 were analysed retrospectively. The study population comprised 275 patients who were divided by gender. The primary endpoint of the study was all-cause mortality at 1 year. Results Women constituted 132 (48.0%) of the overall population. Women were significantly older, but had a significantly higher left ventricular ejection fraction (LVEF) and had less frequently undergone coronary artery bypass grafting (CABG) before TAVI. The implantation success rate was comparable between genders, but women less frequently required implantation of a pacemaker after TAVI, although they more frequently required blood transfusion due to severe bleeding. The primary endpoint occurred in 13.6% of women and 7.7% of men ( p = 0.12). Conclusions Despite advanced age and prevalence of cardiovascular risk factors, the overall short- and medium-term mortality in patients treated with TAVI in our analysis of the real-world population remains relatively low. Although women seemed to have a slightly better clinical baseline profile, their in-hospital, 30-day, 6-month and 12-month outcomes did not differ significantly from the male patients.

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“…As the disease worsens, symptoms such as angina and dizziness may appear [ 3 ]. If aortic valve stenosis cannot be treated in time, it can also lead to complications such as heart failure, arrhythmia, congestive heart failure, infective endocarditis, systemic embolism, and gastrointestinal bleeding [ 4 ]. TAVI is an interventional therapy that has emerged in recent years to treat aortic valve stenosis.…”

Section: Introductionmentioning

confidence: 99%

OS-LALM-OGM Algorithm-Based Computed Tomography Image for Characteristics and Comorbidities of Patients before Transcatheter Aortic Valve Implantation

Sun

Tan

et al. 2021

Journal of Healthcare Engineering

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Based on the ordered subsets (OS), a linear augmentation Lagrangian method (OS-LALM) was constructed, which was then combined with the optimized gradient method (OGM) to construct the OS-LALM-OGM, so as to discuss application of the computed tomography (CT) images based on OS-LALM-OGM in evaluation of clinical manifestations and complications of patients before transcatheter aortic valve implantation (TAVI). The OS-LALM-OGM was compared with the filtered back projection (FBP) and OS-LALM. In addition, it was applied to evaluate the conditions of 128 patients before TAVI. It was found that the peak signal-to-noise ratio (PSNR) of OS-LALM-OGM was greater than that of the FBP and OS-LALM when the number of iterations was 5, 20, and 40, while the root mean square error (RMSD) was the opposite ( P < 0.05 ). The proportion of dyspnea was the highest, 38.28%, followed by angina (19.53%) and fainting (21.09%). The long diameter of the annulus and the average inner diameter of the annulus measured by the CT image based on the OS-LALM-OGM algorithm were greatly larger than the inner diameter of the aortic annulus measured by the CT based on the FBP algorithm ( P < 0.05 ); the evaluation sensitivity (95.24%) and specificity (85.85%) of CT based on the OS-LALM-OGM algorithm were obviously greater than those of X-ray, which were 84.43% and 76.77%, respectively ( P < 0.05 ). In short, the OS-LALM-OGM proposed had a relatively excellent effect on CT image reconstruction. The CT image based on the OS-LALM-OGM algorithm showed a better evaluation performance for patients before TAVI than the traditional FBP algorithm, showing higher sensitivity and specificity.

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Vascular access site complications after transfemoral transcatheter aortic valve implantation in the POL-TAVI Registry: surgical versus percutaneous approach

Cited by 5 publications

References 17 publications

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

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

Female gender and the clinical and periprocedural profile and clinical outcomes of transcatheter aortic valve implantation: experiences of a tertiary Polish centre

OS-LALM-OGM Algorithm-Based Computed Tomography Image for Characteristics and Comorbidities of Patients before Transcatheter Aortic Valve Implantation

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