Safety and efficacy of hybrid vascular closure technique using both a suture‐ and collagen‐mediated closure device after transfemoral transcatheter aortic valve implantation

Abstract

Objectives: To evaluate the clinical utility and feasibility of a hybrid technique for obtaining vascular hemostasis by combining a suture-and a collagen-mediated system after transfemoral transcatheter aortic valve implantation (TF TAVI) in a real-world setting.Methods: In 75 consecutive TF TAVI procedures, we investigated a hybrid closing method to achieve hemostasis at the large bore puncture site using a combination of one presuture closure system (ProGlide) and one collagen-mediated system (Angio-Seal). Vascular complications at puncture site were recorded until discharge. Results: Successful hemostasis by the hybrid technique was achieved in 74 out of 75 patients, and the method was well tolerated by all patients. In 73 patients, (97.3%) neither puncture site related complications nor serious early or late bleedings were observed during a median hospital stay of 2 days postprocedure.Conclusion: This single-center registry study indicates that a percutaneous hybrid closure technique is safe and efficacious in closing large bore arteriotomies. It is an easy and reliable technique that may contribute to simplifying TAVI procedures.Study registration: The data was collected from an internal quality control registry on treatment of patients with valvular heart disease with or without coronary artery disease, No 2014/17280,

Impact of Transcatheter Aortic Valve Implantation on Thrombin Generation and Platelet Function

“…Interestingly, bleeding risk decreased during the past years due to evolution of closure devices and TAVI delivery catheters. [34][35][36] Additionally, intraprocedural ACT-guided UFH administration reduced risk for bleeding as well. 9 Moreover, anticoagulation is more effective in preventing leaflet thrombosis in comparison to antiplatelet therapy.…”

Closing up after TAVR

“…Al‐Ani et al 1 report a series of 75 patients who underwent percutaneous closure of the femoral arteriotomy using a “hybrid” closure technique. Much of the vascular access and closure approach in transcatheter aortic valve replacement (TAVR), and indeed so much of the overall procedure itself, is in a state of constant evolution that the entire procedure could be considered a hybrid of devices and methods.…”