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Region Hovedstaden - en del af Københavns Universitetshospital
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Feasibility and safety of transcaval transcatheter aortic valve implantation: a multicentre European registry

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • Giulia Costa
  • Ole De Backer
  • Thomas Pilgrim
  • Markus Kasel
  • Simon Redwood
  • Adel Aminian
  • Jonas Lanz
  • Jonathan Michel
  • Tiffany Patterson
  • Stephan Windecker
  • Bernard Prendergast
  • Adam B Greenbaum
  • Lars Søndergaard
Vis graf over relationer

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 high-risk patients with severe aortic stenosis not suitable for transfemoral or transaxillary/subclavian transarterial access.

OriginalsprogEngelsk
TidsskriftEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Vol/bind15
Udgave nummer15
Sider (fra-til)e1319-e1324
ISSN1774-024X
DOI
StatusUdgivet - 7 feb. 2020

ID: 59143939