Vascular Access Complications and Clinical Outcomes of Vascular Surgical Repairs Following Transcatheter Aortic Valve Implantation (TAVI)

Sinclair, Nicholas; Mordhorst, Alexa; Yang, Gary K.; MacDonald, P.S.; Sidhu, Ravi; Reid, John D.

doi:10.1016/j.avsg.2020.12.032

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…In a recent study conducted in North America, 3.7% of major artery injuries were observed. 19 With careful patient selection, increasing experience, development of access techniques, and reduction of sheath sizes, major artery injuries are expected to decrease to even lower levels.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Balloon-Expandable and Self-Expandable Valves in Patients with Transcatater Aortic Valve Implantation in Terms of Demographic and Complications and Evaluation of the Predictors of Complications: A Retrospective Single Center Experience

KILIÇ,

GÜZEL,

AKTAN

et al. 2023

Turkiye Klinikleri J Cardiovasc Sci

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Transcatheter aortic valve implantation (TAVI) offers an alternative to surgery for patients with symptomatic severe aortic stenosis. Currently, the most commonly used valves for clinical use are the Balloon-expandable Edwards SAPIEN and Self-expandable CoreValve Revalving valves. The aim of our study is to compare these valve types used in TAVI procedures performed in our center and to determine the predictors of complications. Material and Methods: 96 patients who underwent TAVI in our center were included in our study. Pre-procedural clinical, laboratory and echocardiographic data of patients who underwent TAVI were reviewed retrospectively. Results: Complications developed in 31 (32.3%) of the patients. Total complications were found to be higher in patients with balloon-expandable valve (18 vs. 13, p=0.036, respectively). In patients who developed complications, hemoglobin and hematocrit values at the time of admission to the hospital were found to be significantly lower, and C-reactive protein was found to be high. Among the echocardiographic findings at admission, the aortic valve area was found to be narrower and the maximum and mean gradient was higher in patients with complications. Conclusion: In our study, a lower complication rate was observed in self-expandable valves. Some independent markers of TAVI-specific complications and mortality were identified. Examination of new predictors and development of a TAVI-specific scoring system may be considered in future prospective controlled studies.

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Section: Discussionmentioning

confidence: 99%

Comparison of Balloon-Expandable and Self-Expandable Valves in Patients with Transcatater Aortic Valve Implantation in Terms of Demographic and Complications and Evaluation of the Predictors of Complications: A Retrospective Single Center Experience

KILIÇ,

GÜZEL,

AKTAN

et al. 2023

Turkiye Klinikleri J Cardiovasc Sci

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“…In all the reported cases, we would therefore recommend an interventional procedure. Nevertheless, the involvement of surgical expertise is essential in all these cases, because there will be patients, in whom the surgical therapy, such as hematoma evacuation, suturing, endarterectomy with patch of the common or superficial femoral artery, bypass surgery or hybrid approach will be required ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Interventional Treatment of Access Site Complications During Transfemoral TAVI: A Single Center Experience

Thieme

Moebius-Winkler

Franz

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Transcatheter aortic valve implantation (TAVI) has rapidly developed over the last decade and is nowadays the treatment of choice in the elderly patients irrespective of surgical risk. The outcome of these patients is mainly determined not only by the interventional procedure itself, but also by its complications.Material and Methods: We analyzed the outcome and procedural events of transfemoral TAVI procedures performed per year at our institution. The mean age of these patients is 79.2 years and 49% are female. All the patients underwent duplex ultrasonography of the iliac arteries and inguinal vessels before the procedure and CT of the aorta and iliac arteries.Results: Transfemoral access route is associated with a number of challenges and complications, especially in the patients suffering from peripheral artery disease (PAD). The rate of vascular complications at our center was 2.76% (19/689). Typical vascular complications (VC) include bleeding and pseudoaneurysms at the puncture site, acute or subacute occlusion of the access vessel, and dissection or perforation of the iliac vessels. In addition, there is the need for primary PTA of the access pathway in the presence of additional PAD of the common femoral artery (CFA) and iliac vessels. Balloon angioplasty, implantation of covered and uncovered stents, lithoplasty, and ultrasound-guided thrombin injection are available to treat the described issues.Conclusion: Interventional therapy of access vessels can preoperatively enable the transfemoral approach and successfully treat post-operative VC in most of the cases. Training the heart team to address these issues is a key focus, and an interventional vascular specialist should be part of this team.

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“…Pre-procedural planning is paramount and has a direct impact on the feasibility of TF TAVI. Vascular minimal diameter, tortuosity, and extent and distribution of calcification are major predictors of vascular complications and the success of the procedure [87,88]. The induction of newer low-profile devices with smaller sheath sizes (16 and 14 Fr) has reduced a lot the rates of vascular access-related complications.…”

Section: Patients With Limited Transfemoral Accessmentioning

confidence: 99%

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

Mitsis

Yuan

Eftychiou

et al. 2022

JCDD

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Transcatheter aortic valve replacement (TAVI) has become a game changer in the management of severe aortic stenosis shifting the concept from inoperable or high-risk patients to intermediate or low surgical-risk individuals. Among devices available nowadays, there is no clear evidence that one device is better than the other or that one device is suitable for all patients. The selection of the optimal TAVI valve for every patient represents a challenging process for clinicians, given a large number of currently available devices. Consequently, understanding the advantages and disadvantages of each valve and personalising the valve selection based on patient-specific clinical and anatomical characteristics is paramount. This review article aims to both analyse the available devices in the presence of specific clinical and anatomic features and offer guidance to select the most suitable valve for a given patient.

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Vascular Access Complications and Clinical Outcomes of Vascular Surgical Repairs Following Transcatheter Aortic Valve Implantation (TAVI)

Cited by 5 publications

References 13 publications

Comparison of Balloon-Expandable and Self-Expandable Valves in Patients with Transcatater Aortic Valve Implantation in Terms of Demographic and Complications and Evaluation of the Predictors of Complications: A Retrospective Single Center Experience

Comparison of Balloon-Expandable and Self-Expandable Valves in Patients with Transcatater Aortic Valve Implantation in Terms of Demographic and Complications and Evaluation of the Predictors of Complications: A Retrospective Single Center Experience

Interventional Treatment of Access Site Complications During Transfemoral TAVI: A Single Center Experience

Personalised Treatment in Aortic Stenosis: A Patient-Tailored Transcatheter Aortic Valve Implantation Approach

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