A1 Refereed original research article in a scientific journal
Impact of Major Vascular Complication Access Site Status on Mortality After Transfemoral Transcatheter Aortic Valve Replacement - Results From the FinnValve Registry
Authors: Laakso Teemu, Moriyama Noriaki, Raivio Peter, Dahlbacka Sebastian, Kinnunen Eeva-Maija, Juvonen Tatu, Valtola Antti, Husso Annastiina, Jalava Maina P., Ahvenvaara Tuomas, Tauriainen Tuomas, Piuhola Jarkko, Lahtinen Asta, Niemelä Matti, Mäkikallio Timo, Virtanen Marko, Maaranen Pasi, Eskola Markku, Savontaus Mikko, Airaksinen Juhani, Biancari Fausto, Laine Mika
Publisher: Japanese Circulation Society
Publication year: 2020
Journal: Circulation reports
Journal name in source: Circulation reports
Journal acronym: Circ Rep
Volume: 2
Issue: 3
First page : 182
Last page: 191
ISSN: 2434-0790
eISSN: 2434-0790
DOI: https://doi.org/10.1253/circrep.CR-20-0007
Web address : https://www.jstage.jst.go.jp/article/circrep/2/3/2_CR-20-0007/_article
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/69071063
Background: The aim of this study was to investigate the impact of anatomical site status and major vascular complication (MVC) severity on the outcome of transfemoral transcatheter aortic valve replacement (TF-TAVR).
Methods and Results: The FinnValve registry enrolled consecutive TAVR patients from 2008 to 2017. MVC was divided into 2 groups: non-access site-related MVC (i.e., MVC in aorta, aortic valve annulus or left ventricle); and access site-related MVC (i.e., MVC in iliac or femoral arteries). Severity of access site-related MVC was measured as units of red blood cell (RBC) transfusion. Of 1,842 patients who underwent TF-TAVR, 174 had MVC (9.4%; non-access site related, n=29; access site related, n=145). Patients with MVC had a significantly higher 3-year mortality than those without MVC (40.8% vs. 24.3%; HR, 2.01; 95% CI: 1.16-3.62). Adjusted 3-year mortality risk was significantly increased in the non-access site-related MVC group (mortality, 77.8%; HR, 4.30; 95% CI: 2.63-7.02), but not in the access site-related MVC group (mortality, 32.6%; HR, 1.38; 95% CI: 0.86-2.15). In the access site-related MVC group, only those with RBC transfusion ≥4 units had a significantly increased 3-year mortality risk (mortality, 51.8%; HR, 2.18; 95% CI: 1.19-3.89).
Conclusions: In patients undergoing TF-TAVR, MVC was associated with an increased 3-year mortality risk, incrementally correlating with anatomical site and bleeding severity.
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