Most relevant complications of transcatheter aortic valve implantation related to the site of implantation: Results of Slovenian national registry

Abstract

Background: Transfemoral valve implantation is the most widely used approach for transcatheter aortic valve implantation (TAVI) and transapical approach is considered to be associated with increased morbidity and mortality. The aim of our study was to compare TAVI related complications in trasfemoral and transapical approach and to compare the long-term outcome in these two groups. Methods and results: We enrolled 171 patients who underwent transfemoral or transapical TAVI between October 2009 and January 2015 (143 transfemoral approach, 28 transapical approach). Patients with transapical approach were more often men and more of them had coronary artery disease and carotid stenosis. The most common complications were related to vascular damage that resulted in minor bleeding and were more common in transfemoral approach. There were no other significant differences in periprocedural complications between transfemoral and transapical site of implantation. We observed no statistical difference in 30 days survival between transfemoral and transapical approach, but long-term survival was better with the transfemoral approach (log Rank = 0.025). Conclusions: We observed comparable results with transfemoral and transapical TAVI approach. The long-term survival, which was better in transfemoral group, could be improved with valve and access route individualization to each patient's anatomy and general condition. aged, aortic valve stenosis, aortic valve replacement, transcatheter, postoperative complications/ mortality

Trends in Mortality From Aortic Stenosis in Europe: 2000–2017

“…Procedural complications and mortality reduce with greater TAVI experience ( 19 ), which may contribute, along with the greater TAVI numbers, to the declining AS mortality in these countries. Conversely, Croatia had only performed 87 TAVIs by 2014 ( 20 ), Slovenia was a slow adopter and had only performed procedures in one centre in 2015 ( 21 ) and Poland has among the lowest numbers of TAVI procedures in Europe ( 22 ). Portugal, a Western European country with increasing AS mortality, had the lowest number of TAVI procedures in Europe (7 per 1,000,000 population/year) in 2013 ( 23 ).…”