A less-invasive totally-endovascular (LITE) technique for trans-femoral transcatheter aortic valve replacement

Francesco Burzotta, Piergiorgio Bruno, Carlo Trani, Cristina Aurigemma, Giulio Russo, Aniello Zambrano, Antonio Maria Leone, Osama Shoeib

Risultato della ricerca: Contributo in rivistaArticolo in rivista

7 Citazioni (Scopus)

Abstract

Objectives: To describe and report the results of an original technique for trans-femoral (TF) transcatheter-aortic-valve-replacement (TAVR). Background: TF approach represents the commonest TAVR technique. The best technique for TF-TAVR is not recognized. Methods: We developed a less-invasive totally-endovascular (LITE) technique for TF-TAVR. The key aspects are: precise TAVR access puncture using angiographic-guidewire-ultrasound guidance radial approach as the “secondary access” (to guide valve positioning, to check femoral-access hemostasis and to manage eventual access-site complications) non-invasive pacing (by retrograde left ventricle stimulation or by definitive pace-maker external programmer). The LITE technique has been systematically adopted at our Institution. Procedure details, complications and clinical events occurring during hospitalization were prospectively recorded. Major vascular complications and life-threatening or major bleedings were the primary study end-points. Results: A total of 153 consecutive patients referred for TF-TAVR were approached using the LITE technique. Mean predicted surgical operative mortality was 4.9% and mean TAVR predicted mortality was 3.9%. In 132 (86.3%) patients, TAVR was completed without the need for additional femoral artery access or transvenous temporary pace-maker implantation. Major vascular complications occurred in 2 (1.3%), life-threatening or major bleedings occurred in 4 (2.6%) patients. All-cause death occurred in 3 patients (2.0%). Conclusions: TF-TAVR according to LITE technique is feasible and is associated with very low rates of vascular or bleeding complications.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaCatheterization and Cardiovascular Interventions
Volume2020
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • endovascular interventions
  • personalized medicine
  • temporary pace-maker
  • trans-femoral approach
  • trans-radial approach
  • transcatheter-aortic-valve-replacement

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