Expandable sheath for transfemoral transcatheter aortic valve replacement: Procedural outcomes and complications. Issue 6 (31st January 2014)

• Record Type: Journal Article
• Authors: Borz, Bogdan; Durand, Eric; Tron, Christophe; Godin, Matthieu; Canville, Alexandre; Hauville, Camille; Cribier, Alain; Eltchaninoff, Hélène
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 6(2014:May 01)
• Page Start: E227
• Page End: E232
• Publication Date: 2014-01-31
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25390
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25390-sec-0001" sec-type="section"> <title>Aims</title> <p>It is currently unknown whether the expandable sheath (e‐sheath) for transfemoral Edwards transcatheter aortic valve replacement (TAVR) has a lower rate of access complications than the 18/19F fixed size sheath (f‐sheath). Our aim was to compare the incidence of procedural complications when using f‐sheath vs. e‐sheath during TAVR.</p> </sec> <sec id="ccd25390-sec-0002" sec-type="section"> <title>Methods</title> <p>We included 162 consecutive patients, implanted with the Edwards SAPIEN XT valve in our center. Access closure was obtained with the Prostar system in all cases. E‐sheath was used in 80 patients (49%).</p> </sec> <sec id="ccd25390-sec-0003" sec-type="section"> <title>Results</title> <p>Minimal ilio‐femoral diameter was comparable in e‐sheath and f‐sheath groups: 6.7 (6.1–7.7) vs. 7 (6.2–8) mm, <italic>P</italic> = 0.25, as was the frequency of peripheral artery disease: 12.5% vs. 13.4%, <italic>P</italic> = 1.0. VARC major vascular complications rate was similar in the 2 groups: e‐sheath 7 (8.8%) vs. f‐sheath 6 (7.3%), <italic>P</italic> = 0.74, as was the incidence of minor vascular complications: 8 (10%) vs. 14 (17.1%), <italic>P</italic> = 0.19, life‐threatening bleeding: 6 (7.5%) vs. 6 (7.3%), <italic>P</italic> = 0.96, major and minor bleeding and use of covered vascular stents: 9 (11%) vs. 6 (7.5%), <italic>P</italic> = 0.59.</p> </sec> <sec id="ccd25390-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The e‐sheath for TAVR with the Edwards valve did not show an advantage over the f‐sheath in reducing vascular and bleeding complications. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>