Procedural success in transaxillary transcatheter aortic valve implantation according to type of transcatheter heart valve: results from the multicenter TAXI registry.

Autor: Schaefer A; Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistraße 52, 20246, Hamburg, Germany. and.schaefer@uke.de., Bhadra OD; Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistraße 52, 20246, Hamburg, Germany., Conradi L; Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistraße 52, 20246, Hamburg, Germany., Westermann D; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany., Kellner C; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany., De Backer O; The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Bajoras V; The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.; Department of Interventional Cardiology, Division of Cardiology and Vascular Diseases, Vilnius University, Hospital Santaros Clinics, Vilnius, Lithuania., Sondergaard L; The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Qureshi WT; Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA., Kakouros N; Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA., Aldrugh S; Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA., Amat-Santos I; Cardiology Department, CIBERCV, Hospital Clinico Universitario de Valladolid, Valladolid, Spain., Kaneko T; Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Harloff M; Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Teles R; Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal., Nolasco T; Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal., Neves JP; Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal., Abecasis M; Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal., Werner N; Department of Medicine 3, Barmherzige Brüder Hospital, Trier, Germany., Lauterbach M; Department of Medicine 3, Barmherzige Brüder Hospital, Trier, Germany., Sacha J; Department of Cardiology, Institute of Medical Sciences, University Hospital, University of Opole, Opole, Poland., Krawczyk K; Department of Cardiology, Institute of Medical Sciences, University Hospital, University of Opole, Opole, Poland., Trani C; Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy., Romagnoli E; Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy., Mangieri A; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy., Condello F; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy., Regueiro A; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain., Brugaletta S; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain., Biancari F; Clinica Montevergine, GVM Care & Research, Mercogliano, Italy.; Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland., Niemelä M; Department of Internal Medicine, Oulu University Hospital, Oulu, Finland., Giannini F; Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy., Toselli M; Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy., Ruggiero R; Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy., Buono A; Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy., Maffeo D; Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy., Bruno F; Department of Medical Science, Division of Cardiology, Città Della Salute e della Scienza, Turin, Italy., Conrotto F; Department of Medical Science, Division of Cardiology, Città Della Salute e della Scienza, Turin, Italy., D'Ascenzo F; Department of Medical Science, Division of Cardiology, Città Della Salute e della Scienza, Turin, Italy., Savontaus M; Heart Center, Turku University Hospital, University of Turku, Turku, Finland., Pykäri J; Heart Center, Turku University Hospital, University of Turku, Turku, Finland., Ielasi A; IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy., Tespili M; Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan, Italy., Cimmino M; Interventional Cardiology Unit, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy., Albanese M; Interventional Cardiology Unit, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy., Biondi-Zoccai G; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.; Mediterranea Cardiocentro, Naples, Italy., Corcione N; Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy., Morello A; Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy., Giordano A; Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jan; Vol. 113 (1), pp. 48-57. Date of Electronic Publication: 2023 May 04.
DOI: 10.1007/s00392-023-02216-1
Abstrakt: Background: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI.
Aims: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV).
Methods: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers. Acute procedural, early and 1-month clinical outcomes were adjudicated in accordance with standardized VARC-3 definitions.
Results: From 432 patients, 368 patients (85.3%, SE group) received self-expanding (SE) THV and 64 patients (14.8%, BE group) received balloon-expandable (BE) THV. Imaging revealed lower axillary artery diameters in the SE group (max/min diameter in mm: 8.4/6.6 vs 9.4/6.8 mm; p < 0.001/p = 0.04) but a higher proportion of axillary tortuosity in BE group (62/368, 23.6% vs 26/64, 42.6%; p = 0.004) with steeper aorta-left ventricle (LV) inflow (55° vs 51°; p = 0.002) and left ventricular outflow tract (LVOT)-LV inflow angles (40.0° vs 24.5°; 0.002). TAx-TAVI was more often conducted by right sided axillary artery in the BE group (33/368, 9.0% vs 17/64, 26.6%; p < 0.001). Device success was higher in the SE group (317/368, 86.1% vs 44/64, 68.8%, p = 0.0015). In logistic regression analysis, BE THV were a risk factor for vascular complications and axillary stent implantation.
Conclusions: Both, SE and BE THV can be safely used in TAx-TAVI. However, SE THV were more often used and were associated with a higher rate of device success. While SE THV were associated with lower rates of vascular complications, BE THV were more often used in cases with challenging anatomical circumstances.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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