Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation

Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation

Abstract OBJECTIVES The aim of this study was to investigate the impact of Valve Academic Research Consortium 3 minor access site vascular complications (VCs) in patients who underwent percutaneous transfemoral (TF) transcatheter aortic valve implantation (TAVI). METHODS This single-centre retrospec...

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Veröffentlicht in:European journal of cardio-thoracic surgery 2023-08, Vol.64 (2)
Hauptverfasser: Piperata, Antonio, Van den Eynde, Jef, Pernot, Mathieu, Avesani, Martina, Seguy, Benjamin, Bonnet, Guillaume, Ben Ali, Walid, Leroux, Lionel, Labrousse, Louis, Modine, Thomas
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container_title European journal of cardio-thoracic surgery
container_volume 64
creator Piperata, Antonio
Van den Eynde, Jef
Pernot, Mathieu
Avesani, Martina
Seguy, Benjamin
Bonnet, Guillaume
Ben Ali, Walid
Leroux, Lionel
Labrousse, Louis
Modine, Thomas
description Abstract OBJECTIVES The aim of this study was to investigate the impact of Valve Academic Research Consortium 3 minor access site vascular complications (VCs) in patients who underwent percutaneous transfemoral (TF) transcatheter aortic valve implantation (TAVI). METHODS This single-centre retrospective study included consecutive patients who underwent percutaneous TF-TAVI from 2009 to 2021. A propensity score-matched analysis was performed to compare early and long-term clinical results between patients with VC and without VC (nVC). RESULTS A total of 2161 patients were included, of whom 284 (13.1%) experienced access site VC. Propensity score analysis allowed to match 270 patients from the VC group with 727 patients from the nVC group. In the matched cohorts, the VC group showed longer operative times (63.5 vs 50.0 min, P 
doi_str_mv 10.1093/ejcts/ezad255
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METHODS This single-centre retrospective study included consecutive patients who underwent percutaneous TF-TAVI from 2009 to 2021. A propensity score-matched analysis was performed to compare early and long-term clinical results between patients with VC and without VC (nVC). RESULTS A total of 2161 patients were included, of whom 284 (13.1%) experienced access site VC. Propensity score analysis allowed to match 270 patients from the VC group with 727 patients from the nVC group. In the matched cohorts, the VC group showed longer operative times (63.5 vs 50.0 min, P &lt; 0.001), higher operative and in-hospital mortality (2.6% vs 0.7%, P = 0.022; and 6.3% vs 3.2%, P = 0.040, respectively), longer hospital length of stay (8 vs 7 days, P = 0.001) and higher rates of blood transfusion (20.4% vs 4.3%, P &lt; 0.001) and infectious complications (8.9% vs 3.8%, P = 0.003). Overall survival during follow-up was significantly lower in the VC group (hazard ratio 1.37, 95% CI 1.03–1.82, P = 0.031) with 5-year survival rates being 58.0% (95% CI 49.5–68.0%) and 70.7% (95% CI 66.2–75.5%) for the VC and nVC groups, respectively. CONCLUSIONS This retrospective study observed that minor access site VCs during percutaneous TF-TAVI can be serious events affecting early and long-term outcomes. As the indication to transcatheter aortic valve implantation (TAVI) is expanding to patients at progressively lower risk [1, 2], the reduction of procedure-related vascular complications (VCs) represents a main objective [3].</description><identifier>ISSN: 1873-734X</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezad255</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European journal of cardio-thoracic surgery, 2023-08, Vol.64 (2)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c303t-87b9c1f2a3814b67af25c5e95b216590f966ad65349ec6576f94a5324c28f7db3</citedby><cites>FETCH-LOGICAL-c303t-87b9c1f2a3814b67af25c5e95b216590f966ad65349ec6576f94a5324c28f7db3</cites><orcidid>0000-0002-7802-8586 ; 0000-0001-8542-9049 ; 0000-0002-3027-1771 ; 0000-0003-4970-4562 ; 0000-0002-5606-376X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Piperata, Antonio</creatorcontrib><creatorcontrib>Van den Eynde, Jef</creatorcontrib><creatorcontrib>Pernot, Mathieu</creatorcontrib><creatorcontrib>Avesani, Martina</creatorcontrib><creatorcontrib>Seguy, Benjamin</creatorcontrib><creatorcontrib>Bonnet, Guillaume</creatorcontrib><creatorcontrib>Ben Ali, Walid</creatorcontrib><creatorcontrib>Leroux, Lionel</creatorcontrib><creatorcontrib>Labrousse, Louis</creatorcontrib><creatorcontrib>Modine, Thomas</creatorcontrib><title>Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation</title><title>European journal of cardio-thoracic surgery</title><description>Abstract OBJECTIVES The aim of this study was to investigate the impact of Valve Academic Research Consortium 3 minor access site vascular complications (VCs) in patients who underwent percutaneous transfemoral (TF) transcatheter aortic valve implantation (TAVI). METHODS This single-centre retrospective study included consecutive patients who underwent percutaneous TF-TAVI from 2009 to 2021. A propensity score-matched analysis was performed to compare early and long-term clinical results between patients with VC and without VC (nVC). RESULTS A total of 2161 patients were included, of whom 284 (13.1%) experienced access site VC. Propensity score analysis allowed to match 270 patients from the VC group with 727 patients from the nVC group. In the matched cohorts, the VC group showed longer operative times (63.5 vs 50.0 min, P &lt; 0.001), higher operative and in-hospital mortality (2.6% vs 0.7%, P = 0.022; and 6.3% vs 3.2%, P = 0.040, respectively), longer hospital length of stay (8 vs 7 days, P = 0.001) and higher rates of blood transfusion (20.4% vs 4.3%, P &lt; 0.001) and infectious complications (8.9% vs 3.8%, P = 0.003). Overall survival during follow-up was significantly lower in the VC group (hazard ratio 1.37, 95% CI 1.03–1.82, P = 0.031) with 5-year survival rates being 58.0% (95% CI 49.5–68.0%) and 70.7% (95% CI 66.2–75.5%) for the VC and nVC groups, respectively. CONCLUSIONS This retrospective study observed that minor access site VCs during percutaneous TF-TAVI can be serious events affecting early and long-term outcomes. As the indication to transcatheter aortic valve implantation (TAVI) is expanding to patients at progressively lower risk [1, 2], the reduction of procedure-related vascular complications (VCs) represents a main objective [3].</description><issn>1873-734X</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFkUFr3EAMhU1poWnaY-86pgc3tsdje47L0qaBQCEkoTejlTXJBHvGHY0D7T_Lv6s3G2huOekJnr4neFn2uSy-loVRp3xPSU75Lw6V1m-yo7JrVd6q-tfbF_p99kHkviiKRlXtUfZ4Ps1ICYKFGxwfGDaEA0-O4JKFMdIdbIOXEJNbJlBwcrO53ObqC0zOhwhIxCIgLjE8oNAyYgQK0zw6wuTWS3Ae5lWyTwKLHzjeBudvYeZIS0LPYRFIEb1YnkLE8bCs13eceE3YR9MK3z_nVjD69ET-mL2zOAp_ep7H2fX3b1fbH_nFz7Pz7eYiJ1WolHftzlBpK1RdWe-aFm2lSbPRu6pstCmsaRocGq1qw9TotrGmRq2qmqrOtsNOHWcnB-4cw--FJfWTE-JxPPzeV51SxpiyNqs1P1gpBpHItp-jmzD-6cui31fUP1XUP1f0Hx2W-RXrPyv5mW0</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Piperata, Antonio</creator><creator>Van den Eynde, Jef</creator><creator>Pernot, Mathieu</creator><creator>Avesani, Martina</creator><creator>Seguy, Benjamin</creator><creator>Bonnet, Guillaume</creator><creator>Ben Ali, Walid</creator><creator>Leroux, Lionel</creator><creator>Labrousse, Louis</creator><creator>Modine, Thomas</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7802-8586</orcidid><orcidid>https://orcid.org/0000-0001-8542-9049</orcidid><orcidid>https://orcid.org/0000-0002-3027-1771</orcidid><orcidid>https://orcid.org/0000-0003-4970-4562</orcidid><orcidid>https://orcid.org/0000-0002-5606-376X</orcidid></search><sort><creationdate>20230801</creationdate><title>Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation</title><author>Piperata, Antonio ; Van den Eynde, Jef ; Pernot, Mathieu ; Avesani, Martina ; Seguy, Benjamin ; Bonnet, Guillaume ; Ben Ali, Walid ; Leroux, Lionel ; Labrousse, Louis ; Modine, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-87b9c1f2a3814b67af25c5e95b216590f966ad65349ec6576f94a5324c28f7db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Piperata, Antonio</creatorcontrib><creatorcontrib>Van den Eynde, Jef</creatorcontrib><creatorcontrib>Pernot, Mathieu</creatorcontrib><creatorcontrib>Avesani, Martina</creatorcontrib><creatorcontrib>Seguy, Benjamin</creatorcontrib><creatorcontrib>Bonnet, Guillaume</creatorcontrib><creatorcontrib>Ben Ali, Walid</creatorcontrib><creatorcontrib>Leroux, Lionel</creatorcontrib><creatorcontrib>Labrousse, Louis</creatorcontrib><creatorcontrib>Modine, Thomas</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Piperata, Antonio</au><au>Van den Eynde, Jef</au><au>Pernot, Mathieu</au><au>Avesani, Martina</au><au>Seguy, Benjamin</au><au>Bonnet, Guillaume</au><au>Ben Ali, Walid</au><au>Leroux, Lionel</au><au>Labrousse, Louis</au><au>Modine, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><date>2023-08-01</date><risdate>2023</risdate><volume>64</volume><issue>2</issue><issn>1873-734X</issn><eissn>1873-734X</eissn><abstract>Abstract OBJECTIVES The aim of this study was to investigate the impact of Valve Academic Research Consortium 3 minor access site vascular complications (VCs) in patients who underwent percutaneous transfemoral (TF) transcatheter aortic valve implantation (TAVI). METHODS This single-centre retrospective study included consecutive patients who underwent percutaneous TF-TAVI from 2009 to 2021. A propensity score-matched analysis was performed to compare early and long-term clinical results between patients with VC and without VC (nVC). RESULTS A total of 2161 patients were included, of whom 284 (13.1%) experienced access site VC. Propensity score analysis allowed to match 270 patients from the VC group with 727 patients from the nVC group. In the matched cohorts, the VC group showed longer operative times (63.5 vs 50.0 min, P &lt; 0.001), higher operative and in-hospital mortality (2.6% vs 0.7%, P = 0.022; and 6.3% vs 3.2%, P = 0.040, respectively), longer hospital length of stay (8 vs 7 days, P = 0.001) and higher rates of blood transfusion (20.4% vs 4.3%, P &lt; 0.001) and infectious complications (8.9% vs 3.8%, P = 0.003). Overall survival during follow-up was significantly lower in the VC group (hazard ratio 1.37, 95% CI 1.03–1.82, P = 0.031) with 5-year survival rates being 58.0% (95% CI 49.5–68.0%) and 70.7% (95% CI 66.2–75.5%) for the VC and nVC groups, respectively. CONCLUSIONS This retrospective study observed that minor access site VCs during percutaneous TF-TAVI can be serious events affecting early and long-term outcomes. As the indication to transcatheter aortic valve implantation (TAVI) is expanding to patients at progressively lower risk [1, 2], the reduction of procedure-related vascular complications (VCs) represents a main objective [3].</abstract><pub>Oxford University Press</pub><doi>10.1093/ejcts/ezad255</doi><orcidid>https://orcid.org/0000-0002-7802-8586</orcidid><orcidid>https://orcid.org/0000-0001-8542-9049</orcidid><orcidid>https://orcid.org/0000-0002-3027-1771</orcidid><orcidid>https://orcid.org/0000-0003-4970-4562</orcidid><orcidid>https://orcid.org/0000-0002-5606-376X</orcidid></addata></record>
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title Impact of Valve Academic Research Consortium 3 (VARC-3) minor access site vascular complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation
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