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International Society For Minimally Invasive Cardiothoracic Surgery

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Vascular Access Site Complications After Complete Percutaneous Transfemoral Transcatheter Aortic Valve Implantation
Jan Rychter1, Ryszard Leszek Walas1, Leszek Kukulski1, Michał Hawranek2, Mariusz Gąsior2, Marian Zembala1, Michał Oskar Zembala1
1Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland, 23rd Department of Cardiology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland

BACKGROUND
Aim of the study was to compare vascular access site and bleeding complications according to Vascular Closure Device used to achive a complete percutaneous approach for transfemoral transcatheter aortic valve implantation in a real world, all comers registry.
METHODS
Retrospective study. Data collected from large national TAVI registry, from one of the European countries. The analysis included 1642 patients treated with complete percutaneous transfemoral transcatheter aortic valve implantation in years 2013-2018. 510 patients were treated using Prostar Vascular Closure Device (Abbott Vascular, Santa Clara, California) and 1132 using Proglide Vascular Closure Device (Abbott Vascular, Santa Clara, California). We analysed and compared this two groups on the incidence of vascular and bleeding complications after TAVI. We use unified criteria developed by the Valve Academic Research Consortium (VARC-2) for endpoint assessment and reporting in TAVI trials.
RESULTS
Vascular access site complications were reported in 190 (11,6%) of 1642 patients. The data analysis showed reduced probability of all vascular complications and minor vascular complications in Proglide Vascular Closure Device group, but not major vascular complications. The incidence for overall bleeding complications, life-threatening/disabling bleedings, major and minor bleedings was significantly lower in the patient group treated with Proglide Vascular Closure Device.
CONCLUSIONS
Proglide Vascular Closure Device used for complete percutaneous transfemoral transcatheter aortic valve implantation compared to Prostar Vascular Closure Device is associated with significantly reduced rate of overall and minor vascular access site, but not major vascular complications. Also overall, life threatening, major and minor bleeding complications was significantly lower in the patient group treated with Proglide Vascular Closure Device.


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