Transcatheter Aortic Valve Implantation Using the Transcervical Vascular Access (from a 7-Year Experience from a Swiss Tertiary Center).

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_97538D2481C8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Transcatheter Aortic Valve Implantation Using the Transcervical Vascular Access (from a 7-Year Experience from a Swiss Tertiary Center).
Journal
The American journal of cardiology
Author(s)
Pongan D., Nowacka A., Antiochos P., Muller O., Fournier S., Monney P., Roguelov C., Rancati V., Kirsch M., Lu H.
ISSN
1879-1913 (Electronic)
ISSN-L
0002-9149
Publication state
Published
Issued date
15/08/2023
Peer-reviewed
Oui
Volume
201
Pages
86-91
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The gold-standard transfemoral (TF) access for transcatheter aortic valve implantation (TAVI) is not suitable in 10% to 15% of patients, and alternative accesses are needed. Studies have suggested that the transcervical (TC) access might yield outcomes comparable to the TF access. In our center, TC-TAVI is the first-line alternative to TF-TAVI. We herein present our 7-year experience regarding the use of the TC access in TAVI. We included all consecutive patients referred for TC-TAVI between January 1, 2016 and December 31, 2022. Data regarding the patients' characteristics,perioperative and 30-day outcomes were prospectively collected. Patients were separated into 2 temporal groups (group 1: January 1, 2016 to June 30, 2019; group 2: July 1, 2019 to December 31, 2022) to assess the changes of their characteristics and outcomes over time. A total of 95 patients were included, with more belonging to group 2 (n = 56 vs n = 39 in group 1). Patients in group 2 were significantly younger (81.0 [interquartile range 77.0 to 87.0] vs 89.0 [interquartile range 83.0 to 92.0] years, p <0.001) and had a higher prevalence of hypertension (87.5% vs 66.7%, p = 0.028) and chronic pulmonary disease (35.7% vs 15.4%, p = 0.029). There was no significant difference regarding other co-morbidities or surgical scores. All-cause mortality and the risk of stroke at 30 days were low and similar (group 2 vs group 1, 3.6% vs 2.5%, p = 0.787 and 1.8% vs 0%, p = 0.397, respectively), as were the risks of permanent pacemaker implantation, postoperative acute kidney injury, cardiac tamponade, life-threatening bleeding, and major vascular complications. In conclusion, the use of the TC access increased over time. The rates of adverse events did not change, despite patients from mid-2019 onward having slightly more co-morbidities.
Keywords
Humans, Transcatheter Aortic Valve Replacement/adverse effects, Aortic Valve Stenosis, Switzerland/epidemiology, Postoperative Complications, Femoral Artery/surgery, Treatment Outcome, Aortic Valve/surgery
Pubmed
Web of science
Open Access
Yes
Create date
29/06/2023 16:00
Last modification date
10/02/2024 8:24
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