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VASCULAR COMPLICATIONS OF TRANSFEMORAL AORTIC VALVE IMPLANTATION WITH THE EDWARDS-SAPIEN™ PROSTHESIS
E1612 JACC April 5, 2011 Volume 57, Issue 15
VASCULAR DISEASE VASCULAR COMPLICATIONS OF TRANSFEMORAL AORTIC VALVE IMPLANTATION WITH THE EDWARDSSAPIEN™ PROSTHESIS ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Tuesday, April 05, 2011, 9:30 a.m.-10:45 a.m.
Session Title: Endovascular Therapy - New Technologies and Techniques Abstract Category: 13. Endovascular Therapy Session-Poster Board Number: 1148-98 Authors: Jorge Salgado-Fernandez, Nicolas Vazquez-Gonzalez, Oscar Prada-Delgado, Rodrigo Estevez-Loureiro, Ramon Calviño-Santos, Pablo PiñonEsteban, Jose Joaquin Cuenca-Castillo, Maria Jose Martinez-Sapiña Llanas, Francisco Jose Pombo-Felipe, Antonio Toral-Perez, Alfonso Castro-Beiras, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain Background: Vascular complications (VC) are one of the major drawbacks of transfemoral aortic valve implantation. The aim of this study is to present the VC of transfemoral implantation of Edwards-SAPIEN™ prosthesis in a single-center experience. Methods: After transfemoral implantation of aortic valve prosthesis, VC were assessed by means of routine iliac and femoral angiography. Results: From November 2008 to September 2010, 39 patients (age 83,6 ± 3,7 years; 56,4% female) underwent transfemoral aortic valve implantation using the Edwards-SAPIEN™ prosthesis. Surgical arterial repair was performed in the first 29 patients (Retroflex II delivery system; 24 or 26 French), whereas percutaneous arterial closure with the ProstarXL™ device was performed in the last 10 patients (Novaflex delivery system, 18 or 19 French). We observed VC in 11 patients (28,2%). These were minor VC in 8 patients (arterial dissection with no need of surgical or interventional treatment in 6 patients, and surgical wound infection in 2 patients), and major VC in 3 patients (arterial dissections needing interventional -2 patients- or surgical -1 patient- treatmentt). The main predictor of VC was the ratio between arterial and sheath diameters (1,05 ± 0,007 vs. 1,18 ± 0,21; p=0,009). No complications aroused in the last 10 patients (Novaflex system plus percutaneous closure device, p=0,400). No differences in 30-day mortality were observed between patients with or without VC (0% vs. 9.1%; p=0,834). Post-operative hospital stay was longer only in patients with major VC (10,7 ± 7,2 vs. 5,2 ± 2,9 days; p=0,05). Conclusions: VC of transfemoral aortic valve implantation are frequent, and are influenced by the arterial / sheath diameter ratio. In our series, VC are not related to30-day mortality, although major VC are associated with longer post-operative stay.
VASCULAR DISEASE VASCULAR COMPLICATIONS OF TRANSFEMORAL AORTIC VALVE IMPLANTATION WITH THE EDWARDSSAPIEN™ PROSTHESIS ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Tuesday, April 05, 2011, 9:30 a.m.-10:45 a.m.
Session Title: Endovascular Therapy - New Technologies and Techniques Abstract Category: 13. Endovascular Therapy Session-Poster Board Number: 1148-98 Authors: Jorge Salgado-Fernandez, Nicolas Vazquez-Gonzalez, Oscar Prada-Delgado, Rodrigo Estevez-Loureiro, Ramon Calviño-Santos, Pablo PiñonEsteban, Jose Joaquin Cuenca-Castillo, Maria Jose Martinez-Sapiña Llanas, Francisco Jose Pombo-Felipe, Antonio Toral-Perez, Alfonso Castro-Beiras, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain Background: Vascular complications (VC) are one of the major drawbacks of transfemoral aortic valve implantation. The aim of this study is to present the VC of transfemoral implantation of Edwards-SAPIEN™ prosthesis in a single-center experience. Methods: After transfemoral implantation of aortic valve prosthesis, VC were assessed by means of routine iliac and femoral angiography. Results: From November 2008 to September 2010, 39 patients (age 83,6 ± 3,7 years; 56,4% female) underwent transfemoral aortic valve implantation using the Edwards-SAPIEN™ prosthesis. Surgical arterial repair was performed in the first 29 patients (Retroflex II delivery system; 24 or 26 French), whereas percutaneous arterial closure with the ProstarXL™ device was performed in the last 10 patients (Novaflex delivery system, 18 or 19 French). We observed VC in 11 patients (28,2%). These were minor VC in 8 patients (arterial dissection with no need of surgical or interventional treatment in 6 patients, and surgical wound infection in 2 patients), and major VC in 3 patients (arterial dissections needing interventional -2 patients- or surgical -1 patient- treatmentt). The main predictor of VC was the ratio between arterial and sheath diameters (1,05 ± 0,007 vs. 1,18 ± 0,21; p=0,009). No complications aroused in the last 10 patients (Novaflex system plus percutaneous closure device, p=0,400). No differences in 30-day mortality were observed between patients with or without VC (0% vs. 9.1%; p=0,834). Post-operative hospital stay was longer only in patients with major VC (10,7 ± 7,2 vs. 5,2 ± 2,9 days; p=0,05). Conclusions: VC of transfemoral aortic valve implantation are frequent, and are influenced by the arterial / sheath diameter ratio. In our series, VC are not related to30-day mortality, although major VC are associated with longer post-operative stay.