Computed tomography guided tailored approach to transfemoral access in patients undergoing transcatheter aortic valve implantation
| Autor: | Jacek Legutko, Janusz Konstanty-Kalandyk, Andrzej Gackowski, Maciej Stąpór, Elżbieta Ostrowska-Kaim, Robert Sobczyński, Jarosław Trębacz, Paweł Kleczyński, Łukasz Wiewiórka, Krzysztof Żmudka, Robert Musiał, Krzysztof Piotr Malinowski, Bogusław Kapelak |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
Access route Percutaneous Transcatheter aortic Tailored approach medicine.diagnostic_test business.industry Computed tomography General Medicine Surgery Internal medicine medicine Access site Cardiology Vascular closure device In patient Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology Journal. 30:51-58 |
| ISSN: | 1898-018X 1897-5593 |
| DOI: | 10.5603/cj.a2021.0053 |
| Popis: | Background: Transfemoral approach (TFA) is the most common access route for transcatheter aortic valve implantation (TAVI). Percutaneous femoral access (PA) is preferred over the surgical approach (SA), however, may be associated with a higher risk of access site complications. Thus, we aimed to assess outcomes of computed tomography-guided tailored approach to percutaneous and surgical TFA in patients undergoing TAVI. Methods: We evaluated data of 158 patients, who underwent TAVI via femoral route between January 2017 and December 2018. In the PA group, vascular closure was performed with the use of two percutaneous suture devices and an additional mechanical seal device. We compared complications rate and outcomes. Results: Of the 158 patients (92%; mean age 79.6 years, 60.8% female), in 92 (61%) patients PA was performed and in 66 (39%) patients SA was used. Median (IQR) radiation exposure as well as contrast volume dose was higher in the PA group compared to the SA group 614.0 (410.0; 1104.0) mGy vs. 405 (240.5; 658.0) mGy (p < 0.001) and 150.0 (120.0; 180.7) vs. 130.0 (100.0; 160.0) mL, (p = 0.04), respectively. Bleeding complications were similar in the PA group 11 (12.2%) compared to 5 (8.62%) in the SA group (p = 0.48). Median length of hospital stay was also similar in the PA and the SA group 6.00 (5.00; 8.00) vs 6.00 (4.00; 8.00) days, respectively, p = 0.31). Conclusions: Computed tomography-guided PA in TAVI may provide comparable procedural outcomes compared to the SA, despite a higher radiation dose and the use of contrast dye, while being less invasive. |
| Databáze: | OpenAIRE |
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