- 期刊
Use of Internal Endoconduit for Unfavorable Iliac Artery Anatomy in Patients Undergoing Transcatheter Aortic Valve Replacement - A Single Center Experience
摘要
Background: Transfemoral (TF) access is associated with lower rates of surgical conversion andmortality compared with non-TF access for transcatheter aortic valve replacement (TAVR). Therefore, efforts should be made to make this procedure even less invasive, allowing more TAVR procedures to be performed through femoral access. We herein describe our single-center experience of using one-stage percutaneous internal endoconduits for TAVR in patients with unfavorable iliac artery anatomy. Methods: Between March 2013 andMarch 2016, 113 consecutive patients with severe aortic stenosis at high risk for conventional cardiac surgery underwent TAVR at the Cheng Hsin General Hospital. The patients can be divided into Cohort A (March 2013-December 2014) and Cohort B (January 2015-March 2016). Results: In the Cohort A, 6 out of the 53 (11.4%) with unfavorable iliac artery anatomy were treated by transsubclavian approach (n = 3, 5.7%) or direct aortic approach (n = 3, 5.7%); while in the Cohort B, none (0%) of the 5 patients with unfavorable iliac artery anatomy among 60 consecutive TAVR cases needed non-TF approach (Cohort A vs. Cohort B = 11.4% vs. 0%, p = 0.024) and theywere all successfully treated with the use of an internal endoconduit. Conclusions: The use of internal endoconduits can further increase the number of patients who can be treated through femoral artery access for TAVR and substantially reduce the need of non-TF approaches.
延伸閱讀
- Chen, D. Y., Hsieh, M. J., Chen, C. C., Liu, Y. C., & Hsieh, I. C. (2021). Transcatheter Aortic Valve Implantation in a Patient with Dextrocardia Situs Inversus, and Functional Bicuspid Aortic Valve Stenosis. Acta Cardiologica Sinica, 37(6), 652-656. https://doi.org/10.6515/ACS.202111_37(6).20210601B
- Wu, Y. S., Hsieh, S. R., Wei, H. J., Hsu, C. Y., & Tsai, C. L. (2019). Long-Term Outcomes in Coronary Artery Bypass Graft Patients Using Internal Thoracic Artery with Ipsilateral Arteriovenous Shunt for Hemodialysis. Acta Cardiologica Sinica, 35(4), 387-393. https://doi.org/10.6515/ACS.201907_35(4).20181208A
- Miandoab, S. N., Michler, R. E., Lalezarzadeh, F., Bello, R., & DeRose, J. J. (2014). What Is the Best Proximal Anastomosis for the Free Right Internal Thoracic Artery during Bilateral Internal Thoracic Artery Revascularization? A Prospective, Randomized Study. Cardiology Research and Practice, (2014), aa1-5. https://doi.org/10.1155/2014/972832
- Lee, Y. T., Yin, W. H., Yu, H. P., Tsai, S. K., & Wei, J. (2015). Transcatheter Aortic Valve Implantation in a Woman with Porcelain Aorta, Previous Sternotomy for Coronary Artery Bypass Grafting, and Critical Aortic Stenosis. Acta Cardiologica Sinica, 31(1), 78-82. https://doi.org/10.6515/ACS20140422A
- Ayhan, H., Karaduman, B. D., Keles, T., & Bozkurt, E. (2021). Transcatheter Aortic Valve Implantation in Patients with Connective Tissue Disease. Acta Cardiologica Sinica, 37(1), 38-46. https://doi.org/10.6515/ACS.202101_37(1).20200722A