What is the incidence and impact of vascular complications in patients undergoing transfemoral aortic valve implantation?
Vascular complications are frequent during transfemoral TAVI but decrease with operator experience, highlighting the need for careful patient selection and multidisciplinary management.
AIMS: Vascular complications remain the main limitation of transfemoral aortic valve implantation. Based on a single-centre experience, we aim to detail the type, management and impact of those vascular complications. METHODS AND RESULTS: From October 2006 to January 2009, 54 transfemoral aortic valve implantations were performed using the Edwards SAPIEN prosthesis. Nine patients (16.7%) developed vascular complications. Five patients (9.3%) had ruptures which necessitated a surgical bypass. Four patients (7.4%) had dissection necessitating repair using stenting in all four patients and associated bypass in two of them. Vascular complications led to death in one patient (1.9%), reintervention in one (1.9%), and transfusions in seven (13%). Five vascular complications occurred in the first 20 patients (25%), and only four in the last 34 (12%). CONCLUSIONS: Vascular complications of transfemoral aortic valve implantation are frequent and seem to be influenced by experience. They are associated with a high need for transfusion and could lead to major events such as death or reintervention. These findings highlight the importance of a multidisciplinary approach for patient selection and management of the procedure.
Ducrocq et al. (Fri,) studied this question.