How accurate are manufacturers' recommendations in determining ineligibility for transfemoral transcatheter aortic valve implantation?

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dc.authorid0000-0003-0230-6575
dc.authorid0000-0003-2714-4584
dc.authorid0000-0002-4281-0867
dc.authorid0000-0003-1919-3183
dc.authorid0000-0003-1516-1811
dc.authorid0000-0002-4951-6716
dc.authorid0000-0001-5825-8627
dc.contributor.authorÇakal, Beytullah
dc.contributor.authorÇakal, Sinem
dc.contributor.authorKaraca, Oğuz
dc.contributor.authorKızılırmak Yılmaz, Filiz
dc.contributor.authorGüneş, Hacı Murat
dc.contributor.authorYıldırım, Arzu
dc.contributor.authorGüler, Yeliz
dc.contributor.authorÖzcan, Özgür Ulaş
dc.contributor.authorBoztosun, Bilal
dc.date.accessioned2023-02-22T11:31:01Z
dc.date.available2023-02-22T11:31:01Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractIntroduction: Up to one-third of patients indicated for transcatheter aortic valve implantation (TAVI) may be unsuitable for transfemoral TAVI (TF-TAVI) according to manufacturers' recommendations and numerous professional societies. Objective: This study aimed to investigate the predictive value of manufacturers' guidelines for major vascular access site complications using the Perclose ProGlide device. Methods: Among 208 patients undergoing TF-TAVI, 144 patients (69.2%) were deemed eligible for TF-TAVI according to the manufacturer's instructions. A minimal lumen diameter (MLD) of the femoral artery below the manufacturer's specified limits and/or the presence of circumferential calcification were the reasons for ineligibility. Calcium score (CS), sheath-to-femoral artery ratio (SFAR) and MLD were estimated from computed tomography imaging. Vascular complications (VCs) (defined according to VARC-2 criteria) were retrospectively compared. Results: Patients in the ineligible group had higher SFAR (1.13±0.15 vs. 0.88±0.107, p<0.001) and CS (1.66±0.99 vs. 1.24±0.73; p=0.003), and significantly lower MLD (7.72±1.03 vs. 6.31±0.96 mm; p<0.001) compared to the eligible group. Major (6.3% vs. 12.3%, p=0.13) and minor VCs (10.4% vs. 15.6%, p=0.29) were similar in the eligible and ineligible groups. The ineligible group had higher rates of rupture (0.7% vs. 6.3%; p=0.03). SFAR was the only independent predictor of major VCs (OR 469.1, 95% CI 4.95-44466.57, p=0.008). Conclusion: The TAVI team should not decide whether the patient is suitable for a femoral approach based solely on the manufacturer's criteria, and should incorporate additional factors that could be predictive of major VCs.
dc.identifier.citationÇakal, B., Çakal, S., Karaca, O., Kızılırmak Yılmaz, F., Güneş, H. M., Yıldırım, A. ... Boztosun, B. (2023). How accurate are manufacturers' recommendations in determining ineligibility for transfemoral transcatheter aortic valve implantation? Revista Portuguesa de Cardiologia, 42(1), 31-38. https://doi.org/10.1016/j.repc.2021.09.019
dc.identifier.doi10.1016/j.repc.2021.09.019
dc.identifier.endpage38
dc.identifier.issn0870-2551
dc.identifier.issn2174-2030
dc.identifier.issue1
dc.identifier.pmid36328866
dc.identifier.scopus2-s2.0-85163456767
dc.identifier.scopusqualityQ3
dc.identifier.startpage31
dc.identifier.urihttps://doi.org/10.1016/j.repc.2021.09.019
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10504
dc.identifier.volume42
dc.identifier.wos000921413500001en_US
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÇakal, Beytullah
dc.institutionauthorÇakal, Sinem
dc.institutionauthorKaraca, Oğuz
dc.institutionauthorKızılırmak Yılmaz, Filiz
dc.institutionauthorGüneş, Hacı Murat
dc.institutionauthorYıldırım, Arzu
dc.institutionauthorGüler, Yeliz
dc.institutionauthorÖzcan, Özgür Ulaş
dc.institutionauthorBoztosun, Bilal
dc.language.isoen
dc.publisherSociedade Portuguesa De Cardiologia
dc.relation.ispartofRevista Portuguesa de Cardiologiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAcesso Vascular
dc.subjectAortic Valve Disease
dc.subjectComplications
dc.subjectComplicações
dc.subjectDoença Valvular Aórtica
dc.titleHow accurate are manufacturers' recommendations in determining ineligibility for transfemoral transcatheter aortic valve implantation?
dc.typeArticle

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