title: The routine use of surgical exposure approach for trans-femoral implantation of the balloon expandable aortic prosthesis is associated to a low rate of vascular complications.
abstract: BACKGROUND
  The most frequent complications of transfemoral aortic valve implantation are vascular (15-25%) and are related to an increase in mortality. We sought to assess the rate of vascular complications, its treatment and outcomes using a surgical approach for transfemoral implantation of Edwards-SAPIEN (Edwards Lifescience, Irvine, CA, USA) aortic valve.
  
  
  METHODS
  We have conducted a multicenter registry including 4 hospitals using a systematic surgical exposure approach. Vascular complications have been collected following the definitions of the Valve Academic Research Consortium.
  
  
  RESULTS
  From 2008 to 2013 a total of 312 consecutive patients have been included. Vascular complications were reported in 22 (7%), among those 6 (1.9%) were major whereas 16 (5.1%) were minor. Patients suffering vascular complications had significantly more previous history of peripheral vascular disease. All but one major complications occurred in women, aged 82-88 and with chronic renal failure. Hospital stay was longer in cases suffering complications (17.8±11 days vs. 9±7 days; P<0.0001). The 30 days mortality was 13.6% in patients with vascular complications, 33.3% in patients with major complications and 5.5% in patients with no complications (P=0.05).
  
  
  CONCLUSIONS
  In this registry, the systematic use of a surgical exposure of the femoral artery for TAVR has been associated with a lower rate of vascular complications.
authors: Cardiovascular Department, Marques de Valdecilla University Hospital, Santander, Spain - he1thj@humv.es.
authors: José M
authors: JM
authors: DE LA Torre Hernandez
authors: Raul
authors: R
authors: Moreno
authors: Dae H
authors: DH
authors: Lee
authors: Bruno
authors: B
authors: Garcia Del Blanco
authors: Juan C
authors: JC
authors: Sanmartin
authors: Sergio
authors: S
authors: Garcia Blas
authors: Vicenç
authors: V
authors: Serra Garcia
authors: Koldo
authors: K
authors: Gaviria
authors: Ivan
authors: I
authors: Garcia
authors: Javier
authors: J
authors: Zueco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D063126:Balloon Valvuloplasty / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011677:Punctures; D012042:Registries; D012307:Risk Factors; D013030:Spain; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology*