Vascular complications of transfemoral aortic valve implantation with the Edwards SAPIEN prosthesis: incidence and impact on outcome.
OBJECTIVE
Vascular complications remain the main limitation of transfemoral aortic valve implantation. Based on a single-centre experience, we aim to detail the type, management and impact of those vascular complications.


RESULTS
From October 2006 to January 2009, 54 transfemoral aortic valve implantations were performed using the Edwards SAPIEN prosthesis. Nine patients (16.7%) developed vascular complications. Five patients (9.3%) had ruptures which necessitated a surgical bypass. Four patients (7.4%) had dissection necessitating repair using stenting in all four patients and associated bypass in two of them. Vascular complications led to death in one patient (1.9%), reintervention in one (1.9%), and transfusions in seven (13%). Five vascular complications occurred in the first 20 patients (25%), and only four in the last 34 (12%).


CONCLUSIONS
Vascular complications of transfemoral aortic valve implantation are frequent and seem to be influenced by experience. They are associated with a high need for transfusion and could lead to major events such as death or reintervention. These findings highlight the importance of a multidisciplinary approach for patient selection and management of the procedure.
Department of Cardiology, Bichat-Claude Bernard Hospital, Paris, France. gregory.ducrocq@bch.aphp.fr
Gregory
G
Ducrocq
Fady
F
Francis
Jean-Michel
JM
Serfaty
Dominique
D
Himbert
Jean-Michel
JM
Maury
Nicoletta
N
Pasi
Sami
S
Marouene
Sophie
S
Provenchère
Bernard
B
Iung
Yves
Y
Castier
Guy
G
Lesèche
Alec
A
Vahanian
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014652:Vascular Diseases / Q000453:epidemiology* / Q000209:etiology