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  • Title: The routine use of surgical exposure approach for trans-femoral implantation of the balloon expandable aortic prosthesis is associated to a low rate of vascular complications.
    Author: DE LA Torre Hernandez JM, Moreno R, Lee DH, Garcia Del Blanco B, Sanmartin JC, Garcia Blas S, Serra Garcia V, Gaviria K, Garcia I, Zueco J.
    Journal: J Cardiovasc Surg (Torino); 2016 Aug; 57(4):615-9. PubMed ID: 25673098.
    Abstract:
    BACKGROUND: The most frequent complications of transfemoral aortic valve implantation are vascular (15-25%) and are related to an increase in mortality. We sought to assess the rate of vascular complications, its treatment and outcomes using a surgical approach for transfemoral implantation of Edwards-SAPIEN (Edwards Lifescience, Irvine, CA, USA) aortic valve. METHODS: We have conducted a multicenter registry including 4 hospitals using a systematic surgical exposure approach. Vascular complications have been collected following the definitions of the Valve Academic Research Consortium. RESULTS: From 2008 to 2013 a total of 312 consecutive patients have been included. Vascular complications were reported in 22 (7%), among those 6 (1.9%) were major whereas 16 (5.1%) were minor. Patients suffering vascular complications had significantly more previous history of peripheral vascular disease. All but one major complications occurred in women, aged 82-88 and with chronic renal failure. Hospital stay was longer in cases suffering complications (17.8±11 days vs. 9±7 days; P<0.0001). The 30 days mortality was 13.6% in patients with vascular complications, 33.3% in patients with major complications and 5.5% in patients with no complications (P=0.05). CONCLUSIONS: In this registry, the systematic use of a surgical exposure of the femoral artery for TAVR has been associated with a lower rate of vascular complications.
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