Impact of Major Vascular Complication Access Site Status on Mortality After Transfemoral Transcatheter Aortic Valve Replacement　― Results From the FinnValve Registry ―

Abstract

death after TAVR via the transfemoral (TF) approach, in association with bleeding complication. Although minor vascular complications do not have an impact on mortality, 4 major vascular complication (MVC) is associated with a significant risk of mortality. 4,5 Although MVC involving T ranscatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis (AS). 1,2 Although the feasibility of TAVR has been proved, there are inherent complications related to the procedure. 3 Vascular complication is a significant cause of

Optimal protamine‐to‐heparin dosing ratio for the prevention of bleeding complications in patients undergoing TAVR—A multicenter experience

“…Despite considerable advances in the field of TAVR, including continuing technical and clinical developments, vascular and bleeding complications remain a significant procedure‐specific issue, which affects the outcome of patients. 7 , 9 , 10 Although previous as well as current expert consensus documents recommend the consideration of protamine application for heparin reversal to prevent procedure‐related bleeding, there is no recommendation regarding the dosage of protamine in patients undergoing TAVR. 14 , 15 Thus, daily practice varies significantly between centers, ranging from complete avoidance of the practice to routine administration of protamine in different doses.…”

“… 6 , 7 Nevertheless, TAVR is still associated with several procedure‐specific complications, such as vascular and bleeding events, which have a significant impact on short‐ and long‐term morbidity and mortality. 8 , 9 , 10 Therefore, prevention of bleeding and optimization of the peri‐ and post‐procedural management of vascular complications are paramount to further improvement of patient outcomes following TAVR.…”

“…Over time, the continuing development of transcatheter heart valve (THV) systems and increasing experience, along with recommendations of clinical best practices, have significantly improved patient outcomes by reducing procedure‐related complications 6,7 . Nevertheless, TAVR is still associated with several procedure‐specific complications, such as vascular and bleeding events, which have a significant impact on short‐ and long‐term morbidity and mortality 8–10 . Therefore, prevention of bleeding and optimization of the peri‐ and post‐procedural management of vascular complications are paramount to further improvement of patient outcomes following TAVR.…”

Incidence and Predictors of Access Site Vascular Complications Following Ultrasound-Guided MANTA Closure Deployment

“…In previous reports, major VC has been associated with a 2-to 3-fold increase in 30-day mortality and a 2-fold increase in 36-month mortality. [4][5][6] The current standard for large-bore vascular closure following TF-TAVR is the use of suture-based vascular closure devices (VCDs). Currently, these conventional approaches are being challenged by a new plug-based MANTA VCD (Teleflex, Wayne, PA, USA) consisting of a bioresorbable intra-arterial polymer toggle and an extravascular large collagen plug.…”

“…In previous reports, major VC has been associated with a 2- to 3-fold increase in 30-day mortality and a 2-fold increase in 36-month mortality. 4 - 6 …”