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2016 ; 25
(2
): 99-103
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gab.com Text
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Vascular Complications Associated with Transfemoral Aortic Valve Replacement
#MMPMID27231425
Hines GL
; Jaspan V
; Kelly BJ
; Calixte R
Int J Angiol
2016[Jun]; 25
(2
): 99-103
PMID27231425
show ga
Background?Transfemoral aortic valve replacement (TAVR) is a novel technique for
treating aortic stenosis, yet vascular complications are yet to be delineated.
Objectives?This study aims to study the vascular complications of TAVR with
Edwards Sapien valves (Edwards Lifesciences Corp., Irvine, CA). Methods?We
performed a retrospective evaluation of TAVR patients. Standard demographics,
femoral vessel and sheath size, access type (femoral cut-down [FC], percutaneous
access [PFA], and iliac conduit [IC]), and treatment method were recorded.
Complications were defined by the Valve Academic Research Consortium Criteria.
Logistic regression was used for statistical analysis. Results?A total of 99
patients underwent TAVR between February 15, 2012 and July 17, 2013 with an
Edwards Sapien valve. Out of which, 48 were males with a mean age of 83?±?7
years. Overall, 33 had FC, 58 had PFA, and 6 had an IC. A total of 17 major (2
aortic and 15 iliac) and 38 minor complications (36 access and 2 emboli)
occurred. Aortic complications were managed by open repair (OR, 1) or
percutaneous repair (PR, 1). Overall, 12 iliac injuries were managed by PR and 3
by OR. Out of the 33 groin complications in FC patients 8 (24%) were treated by
OR, whereas 30 (52%) of the 58 groin complications in PTA patients were treated
by PR. There were no differences in transfusion requirements or length of stay.
Conclusion?Vascular complications of TAVR are common with most being minor,
related to access site and causing no immediate sequelae. Iliac injury can be
managed by PR or OR. Aortic injury is associated with significant mortality.
These findings increase vascular surgeons' awareness of these complications and
how to manage them.