Transfemoral aortic valve replacement with the Edwards SAPIEN and Edwards SAPIEN XT prosthesis using exclusively local anesthesia and fluoroscopic guidance: feasibility and 30-day outcomes

JACC. Cardiovascular Interventions
Eric DurandHélène Eltchaninoff

Abstract

The authors report the feasibility and 30-day outcomes of transfemoral aortic valve replacement (TAVR), using the Edwards SAPIEN (Edwards Lifesciences, Irvine, California) and Edwards SAPIEN XT (Edwards Lifesciences) prosthesis, implanted using exclusively local anesthesia and fluoroscopic guidance. Transfemoral TAVR is often managed with general anesthesia. However, a simplified percutaneous approach using local anesthesia has become more popular because it offers multiple advantages in an elderly and fragile population. Between May 2006 and January 2011, the authors prospectively evaluated 151 consecutive patients (logistic EuroSCORE: 22.8 ± 11.8%) who underwent TAVR (SAPIEN: n = 78, SAPIEN XT: n = 73) using only local anesthesia and fluoroscopic guidance. The primary endpoint was a combination of all-cause mortality, major stroke, life-threatening bleeding, stage 3 acute kidney injury (AKI), periprocedural myocardial infarction (MI), major vascular complication, and repeat procedure for valve-related dysfunction at 30 days. Transarterial femoral approach was surgical in all SAPIEN procedures and percutaneous in 97.3% of SAPIEN XT, using the ProStar vascular closure device, and was well tolerated in all cases. Conversion to g...Continue Reading

References

May 16, 2009·Journal of the American College of Cardiology·John G WebbRobert A Boone
Sep 17, 2010·European Heart Journal·Hélène EltchaninoffUNKNOWN FRANCE Registry Investigators
Sep 25, 2010·European Heart Journal·Ralf ZahnUNKNOWN German Transcatheter Aortic Valve Interventions-Registry Investigators
Oct 22, 2010·The New England Journal of Medicine·Martin B LeonUNKNOWN PARTNER Trial Investigators
Nov 16, 2010·European Heart Journal·Thierry LefèvreUNKNOWN PARTNER EU Investigator Group
May 10, 2011·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Ronen GurvitchJohn G Webb
Jun 7, 2011·The New England Journal of Medicine·Craig R SmithUNKNOWN PARTNER Trial Investigators

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Citations

Feb 23, 2013·Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society·Rui LiaoYefeng Zheng
May 20, 2014·Progress in Cardiovascular Diseases·Henrique Barbosa RibeiroJosep Rodés-Cabau
Oct 23, 2013·European Heart Journal·Thomas BartelRebecca T Hahn
Dec 26, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Pierre M SfeirChakib M Ayoub
Feb 20, 2016·The American Journal of Cardiology·Stephen J D BreckerUNKNOWN ADVANCE Study Investigators
Jan 17, 2015·Expert Review of Cardiovascular Therapy·Marc NajjarIsaac George
Jul 31, 2013·Expert Review of Cardiovascular Therapy·Marco Barbanti, John G Webb
May 3, 2016·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Sarkis KiramijyanRon Waksman
Dec 3, 2014·International Journal of Cardiology·Gianni Dall'AraUNKNOWN Transcatheter Valve Treatment Sentinel Registry (TCVT) Investigators of the EurObservational Research Programme (EORP) of th
Aug 26, 2014·International Journal of Cardiology·E M A WiegerinckJ Baan
Oct 31, 2013·The American Journal of Cardiology·Eric DurandHélène Eltchaninoff
Oct 29, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Amar KrishnaswamySamir R Kapadia
Oct 24, 2015·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Silvana MüllerThomas Bartel
May 13, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Anoop M ShahJay Giri
Aug 1, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Mauricio Obon-DentAli Mortazavi
Jan 10, 2014·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Bogdan BorzHélène Eltchaninoff
Mar 30, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Tomas CarvajalHarish Ramakrishna
Jul 1, 2015·Heart·Neil Ruparelia, Bernard D Prendergast
Jun 18, 2015·The American Journal of Cardiology·Guilherme F AttizzaniCorrado Tamburino
Jul 28, 2015·The Canadian Journal of Cardiology·Philipp LangeChristian Kupatt
Sep 27, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Alain CribierHélène Eltchaninoff
Sep 27, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Antonio ColomboAzeem Latib
May 18, 2016·The American Journal of Cardiology·Florence LeclercqGuillaume Cayla
Jul 15, 2016·Nature Reviews. Cardiology·Torsten P Vahl, Susheel K Kodali
Jul 29, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ashish H ShahDoff B McElhinney
Aug 5, 2016·Journal of Cardiovascular and Thoracic Research·Ata Hassani AfsharNader D Nader
Aug 9, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Paola D'ErrigoUNKNOWN OBSERVANT Research Group
Aug 26, 2016·Nature Reviews. Cardiology·Sunil V Rao, Gregg W Stone
Aug 31, 2016·Journal of Cardiac Surgery·Samir V PatelApurva O Badheka
May 16, 2015·Seminars in Cardiothoracic and Vascular Anesthesia·Joyce Lo, Charles Hill
Mar 7, 2018·Expert Review of Cardiovascular Therapy·Marco BarbantiCorrado Tamburino
Oct 25, 2017·Future Cardiology·Mark MariathasNick Curzen
Aug 31, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Roberto NerlaFausto Castriota
Oct 14, 2016·Circulation. Cardiovascular Interventions·Robert HodsonSarah Ramelli
Sep 12, 2018·International Anesthesiology Clinics·Thomas Mader, Jennie Ngai

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