Vascular complications of transfemoral aortic valve implantation with the Edwards SAPIEN prosthesis: incidence and impact on outcome

EuroIntervention. 2010 Jan;5(6):666-72. doi: 10.4244/eijv5i6a110.

Abstract

Aims: Vascular complications remain the main limitation of transfemoral aortic valve implantation. Based on a single-centre experience, we aim to detail the type, management and impact of those vascular complications.

Methods and results: From October 2006 to January 2009, 54 transfemoral aortic valve implantations were performed using the Edwards SAPIEN prosthesis. Nine patients (16.7%) developed vascular complications. Five patients (9.3%) had ruptures which necessitated a surgical bypass. Four patients (7.4%) had dissection necessitating repair using stenting in all four patients and associated bypass in two of them. Vascular complications led to death in one patient (1.9%), reintervention in one (1.9%), and transfusions in seven (13%). Five vascular complications occurred in the first 20 patients (25%), and only four in the last 34 (12%).

Conclusions: Vascular complications of transfemoral aortic valve implantation are frequent and seem to be influenced by experience. They are associated with a high need for transfusion and could lead to major events such as death or reintervention. These findings highlight the importance of a multidisciplinary approach for patient selection and management of the procedure.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / surgery*
  • Catheterization, Peripheral / adverse effects*
  • Catheterization, Peripheral / methods
  • Female
  • Femoral Artery
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis*
  • Hospital Mortality / trends
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Netherlands / epidemiology
  • Postoperative Complications
  • Prospective Studies
  • Prosthesis Design
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Vascular Diseases / epidemiology*
  • Vascular Diseases / etiology