Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)
Procedural success in transaxillary transcatheter aortic valve implantation according to type of transcatheter heart valve: results from the multicenter TAXI registry
Julkaisun tekijät: Schaefer Andreas, Bhadra Oliver D., Conradi Lenard, Westermann Dirk, Kellner Caroline, De Backer Ole, Bajoras Vilhelmas, Sondergaard Lars, Qureshi Waqas T., Kakouros Nikolaos, Aldrugh Summer, Amat-Santos Ignacio, Kaneko Tsuyoshi, Harloff Morgan, Teles Rui, Nolasco Tiago, Neves Jose Pedro, Abecasis Miguel, Werner Nikos, Lauterbach Michael, Sacha Jerzy, Krawczyk Krzysztof, Trani Carlo, Romagnoli Enrico, Mangieri Antonio, Condello Francesco, Regueiro Ander, Brugaletta Salvatore, Biancari Fausto, Niemelä Matti, Giannini Francesco, Toselli Marco, Ruggiero Rossella, Buono Andrea, Maffeo Diego, Bruno Francesco, Conrotto Federico, D’Ascenzo Fabrizio, Savontaus Mikko, Pykäri Jouni, Ielasi Alfonso, Tespili Maurizio, Cimmino Michele, Albanese Michele, Biondi-Zoccai Giuseppe, Corcione Nicola, Morello Alberto, Giordano Arturo
Kustantaja: Springer Heidelberg
Julkaisuvuosi: 2023
Journal: Clinical Research in Cardiology
Tietokannassa oleva lehden nimi: CLINICAL RESEARCH IN CARDIOLOGY
Lehden akronyymi: CLIN RES CARDIOL
Sivujen määrä: 10
ISSN: 1861-0684
DOI: http://dx.doi.org/10.1007/s00392-023-02216-1
Background: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI.
Aims: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV).
Methods: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers. Acute procedural, early and 1-month clinical outcomes were adjudicated in accordance with standardized VARC-3 definitions.
Results: From 432 patients, 368 patients (85.3%, SE group) received self-expanding (SE) THV and 64 patients (14.8%, BE group) received balloon-expandable (BE) THV. Imaging revealed lower axillary artery diameters in the SE group (max/min diameter in mm: 8.4/6.6 vs 9.4/6.8 mm; p < 0.001/p = 0.04) but a higher proportion of axillary tortuosity in BE group (62/368, 23.6% vs 26/64, 42.6%; p = 0.004) with steeper aorta-left ventricle (LV) inflow (55° vs 51°; p = 0.002) and left ventricular outflow tract (LVOT)-LV inflow angles (40.0° vs 24.5°; 0.002). TAx-TAVI was more often conducted by right sided axillary artery in the BE group (33/368, 9.0% vs 17/64, 26.6%; p < 0.001). Device success was higher in the SE group (317/368, 86.1% vs 44/64, 68.8%, p = 0.0015). In logistic regression analysis, BE THV were a risk factor for vascular complications and axillary stent implantation.
Conclusions: Both, SE and BE THV can be safely used in TAx-TAVI. However, SE THV were more often used and were associated with a higher rate of device success. While SE THV were associated with lower rates of vascular complications, BE THV were more often used in cases with challenging anatomical circumstances.
