Ultrasound Guided Technique for Percutaneous Transfemoral Transcatheter Aortic Valve Implantation

Abstract

Aim/objective: The aim of this study was to determine the outcomes of ultrasound-guided technique for patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI) to prevent vascular complications. Method: We report a single centre analysis of 154 patients of a prospectively collected cohort between who underwent transfemoral TAVI using the balloon-expandable Edwards SAPIEN 3 transcatheter heart valve. Patients were divided into two groups (non ultrasound-guided puncture group who underwent TAVI n = 86 compared to those patients who underwent ultrasound-guided puncture n = 68.) The incidence of major vascular complications as defined by The Valve Academic Research Consortium - 2 Criteria (VARC2 criteria) and bleeding complications as defined by the Bleeding Academic Research Consortium (BARC) were used as outcome measures. Results: The incidence of major access site related complications were low and were numerically reduced with ultrasound guided puncture (4.65% vs 0.0%; p = 0.135.) BARC Bleeding criteria greater or equal to 3 was similar between groups (2.33% vs 1.47%; p = NS). Conclusion: This study demonstrates a numerical trend to improved outcomes following the use of ultrasound-guided percutaneous transfemoral puncture for TAVI. This technique has been shown to prevent vascular complications as defined by VARC2 criteria.