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Minimizing the risk for left ventricular rupture during transcatheter aortic valve implantation by reducing the presence of stiff guidewires in the ventricle.
Nielsen, Niels Erik; Baranowska, Julia; Bramlage, Peter; Baranowski, Jacek.
Afiliación
  • Nielsen NE; Department of Cardiology, University Hospital, Linköping, Sweden.
  • Baranowska J; Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Bramlage P; Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany.
  • Baranowski J; Department of Clinical Physiology, University Hospital, Linköping, Sweden.
Interact Cardiovasc Thorac Surg ; 29(3): 365-370, 2019 09 01.
Article en En | MEDLINE | ID: mdl-31135035
OBJECTIVES: The presence of a stiff guidewire in the apex of the left ventricle (LV) is a known risk factor for LV perforation. Our goal was to minimize the risk of LV rupture during transcatheter aortic valve implantation (TAVI) by omitting the interaction between the stiff guidewire and the LV apex using a modified procedure. METHODS: A TAVI protocol designed to allow minimal interaction between a stiff guidewire and the LV was developed in Linköping University Hospital in Sweden. A total of 316 patients were treated exclusively by this approach between March 2014 and May 2018. RESULTS: All procedures were completed successfully. There were no cases (0%) of ventricular perforation. Only 1 patient (0.3%) had a pericardial effusion, and it was due to annulus rupture. There was 1 case of acute kidney injury (0.3%). Five patients (1.6%) required a new permanent pacemaker. Stroke occurred in 3 patients (0.9%). No patient had valve embolization. Vascular complications were experienced by 6 patients (1.9%). A mild paravalvular leak occurred in 27 (8.5%) patients. At 30 days post-TAVI, 6 patients (2%) had died. The mortality rate at 1 year was 8.6% (n = 20/232). CONCLUSIONS: Our series shows that TAVI without the prolonged use of a stiff guidewire in the LV apex is feasible. The risk of LV perforation is eliminated by this approach, and other procedural complications are limited.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Reemplazo de la Válvula Aórtica Transcatéter / Lesiones Cardíacas / Ventrículos Cardíacos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: Interact Cardiovasc Thorac Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Reemplazo de la Válvula Aórtica Transcatéter / Lesiones Cardíacas / Ventrículos Cardíacos Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: Interact Cardiovasc Thorac Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido