Early outcomes of the suprasternal transcatheter aortic valve replacement technique.

Autor: de Oliveira GC; Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Kessel J; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Vavalle J; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Caranasos T; Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jazyk: angličtina
Zdroj: Journal of cardiac surgery [J Card Surg] 2022 Aug; Vol. 37 (8), pp. 2360-2364. Date of Electronic Publication: 2022 May 24.
DOI: 10.1111/jocs.16603
Abstrakt: Background: Transcatheter aortic valve replacement (TAVR) is now an established treatment option for patients with severe aortic stenosis. The most utilized approach remains transfemoral. In patients with difficult femoral access a variety of alternate approaches have been used. Recently, suprasternal access has emerged as a viable alternate approach in patients with very complex vascular access. We describe our 30-day outcomes of patients who underwent suprasternal transcatheter aortic valve replacement (suprasternal [SS]-TAVR), which constitutes the largest single-center cohort to date.
Methods: From May 2016 to September 2021, 658 patients underwent TAVR at our institution. Of which 29 underwent SS-TAVR. We performed a retrospective analysis to evaluate early (30 days) outcomes of this procedure. Main outcomes evaluated included 30-day mortality, stroke and pacemaker rates, length of stay, readmission, and valvular function.
Results: All patients were alive 30 days after the procedure. The median hospital length-of-stay was 2 days. Two patients (6.9%) had a stroke on the contra-lateral side of access. Two patients (6.90%) had significant cardiac arrhythmias requiring pacemaker placement. In 30 days, one patient was readmitted (3.45%).
Conclusions: Our data confirm the SS-TAVR as a feasible and safe alternative with comparable results to established approaches in patients who are unsuitable for femoral artery access and offers clinicians another access site in patients with very complex anatomy.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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