Feasibility and safety of transcaval transcatheter aortic valve implantation: A multicentre European registry
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Feasibility and safety of transcaval transcatheter aortic valve implantation : A multicentre European registry. / Costa, Giulia; De Backer, Ole; Pilgrim, Thomas; Kasel, Markus; Redwood, Simon; Aminian, Adel; Lanz, Jonas; Michel, Jonathan; Patterson, Tiffany; Windecker, Stephan; Prendergast, Bernard; Greenbaum, Adam B.; Søndergaard, Lars.
I: EuroIntervention, Bind 15, Nr. 15, 2020, s. E1319-E1324.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Feasibility and safety of transcaval transcatheter aortic valve implantation
T2 - A multicentre European registry
AU - Costa, Giulia
AU - De Backer, Ole
AU - Pilgrim, Thomas
AU - Kasel, Markus
AU - Redwood, Simon
AU - Aminian, Adel
AU - Lanz, Jonas
AU - Michel, Jonathan
AU - Patterson, Tiffany
AU - Windecker, Stephan
AU - Prendergast, Bernard
AU - Greenbaum, Adam B.
AU - Søndergaard, Lars
PY - 2020
Y1 - 2020
N2 - Aims: A transfemoral transarterial approach is considered the preferable access route for transcatheter aortic valve implantation (TAVI), followed by a transaxillary/subclavian TAVI approach. However, these approaches may not be an option in all patients. This study aimed to report the initial European experience with transfemoral transcaval TAVI. Methods and results: Data on 50 patients treated by transcaval TAVI in five European centres were collected and analysed according to the Valve Academic Research Consortium (VARC)-2 definitions. The study population had a mean age of 78.7±8.0 years and a high surgical risk profile (median STS risk score 6.1%, interquartile range 3.0-11.2%). Transcaval access was successful in 49 out of 50 patients and device success was obtained in 94% of cases. Closure of the caval-aortic puncture site with a nitinol cardiac occluder was successful in all cases without need for emergent surgery. One patient received additional sealing of the aortic puncture site with a covered stent one day post TAVI due to a gradual haemoglobin drop of 3 g/dL. VARC-2-defined life-threatening bleeding and major vascular complications possibly related to transcaval access were 4% and 10%, respectively. There were no bleeding or vascular complications after discharge. At 30 days, the clinical efficacy endpoint was reached in 88% of patients. Conclusions: Transfemoral transcaval access proved to be a feasible and safe TAVI approach for highrisk patients with severe aortic stenosis not suitable for transfemoral or transaxillary/subclavian transarterial access.
AB - Aims: A transfemoral transarterial approach is considered the preferable access route for transcatheter aortic valve implantation (TAVI), followed by a transaxillary/subclavian TAVI approach. However, these approaches may not be an option in all patients. This study aimed to report the initial European experience with transfemoral transcaval TAVI. Methods and results: Data on 50 patients treated by transcaval TAVI in five European centres were collected and analysed according to the Valve Academic Research Consortium (VARC)-2 definitions. The study population had a mean age of 78.7±8.0 years and a high surgical risk profile (median STS risk score 6.1%, interquartile range 3.0-11.2%). Transcaval access was successful in 49 out of 50 patients and device success was obtained in 94% of cases. Closure of the caval-aortic puncture site with a nitinol cardiac occluder was successful in all cases without need for emergent surgery. One patient received additional sealing of the aortic puncture site with a covered stent one day post TAVI due to a gradual haemoglobin drop of 3 g/dL. VARC-2-defined life-threatening bleeding and major vascular complications possibly related to transcaval access were 4% and 10%, respectively. There were no bleeding or vascular complications after discharge. At 30 days, the clinical efficacy endpoint was reached in 88% of patients. Conclusions: Transfemoral transcaval access proved to be a feasible and safe TAVI approach for highrisk patients with severe aortic stenosis not suitable for transfemoral or transaxillary/subclavian transarterial access.
KW - Aortic stenosis
KW - Other
KW - TAVI
U2 - 10.4244/EIJ-D-19-00797
DO - 10.4244/EIJ-D-19-00797
M3 - Journal article
C2 - 31659987
AN - SCOPUS:85083074515
VL - 15
SP - E1319-E1324
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 15
ER -
ID: 250168445