[Transfemoral TAVI procedure in women: Minimally-invasive technique].
Demographic data point to a substantial proportion of women in the population of elderly patients with an increasing prevalence of aortic stenosis. Implantation of an aortic bioprosthesis via an endovascular approach known as Transcatheter aortic valve implantation (TAVI) in patients presenting with a symptomatic tight aortic stenosis (severe aortic stenosis) (AS) is an alternative therapeutic option to surgical aortic valve replacement in patients at high surgical risk or ineligible for surgery. The literature has shown that this technique seems to be particularly beneficial in female patients. In the Partner A trial, the 1-year mortality rate was significantly lower in women compared to their male counterparts. Other data revealed that although women have a higher risk of experiencing periprocedural complications (vascular events, bleeding and stroke), their outcome is good and often better than that of men. These results are continuously improving thanks to the enhancement of techniques and devices. In view of the published reports reflecting the increasing experience of the teams, it clearly appears that the simplification of TAVI procedures has resulted in improved outcomes. We report here the case of a patient treated by means of a "minimalist" approach to TAVI allowing a reduction of the risks inherent in the procedure. This simplified strategy relies on an optimal use of CT scan findings prior to TAVI. The procedure is carried out under local anesthesia and the main access site is sutured percutaneously (Proglides). The radial artery is used as a secondary access site. Contrast medium is diluted and stimulation is administered via the intraventricular guidewire. Direct stenting is performed when deemed feasible on the basis of CT scan results. Simplified procedures such as these contribute to the improvement of TAVI outcomes. However, further studies focusing on female patients are warranted in order to corroborate these findings.
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; ICV-GVM La Roseraie, 120, avenue de la République, 93300 Aubervilliers, France; Hôpital Foch, 40, rue Worth, 92151 Suresnes, France. Electronic address: h.benamer@angio-icps.com.
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Benamer
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Chevalier
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Roy
ICV-GVM La Roseraie, 120, avenue de la République, 93300 Aubervilliers, France; Hôpital Foch, 40, rue Worth, 92151 Suresnes, France.
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MA
Bouzid
ICV-GVM La Roseraie, 120, avenue de la République, 93300 Aubervilliers, France.
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Perdrix
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Garot
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Hovasse
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Unterseeh
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; ICV-GVM La Roseraie, 120, avenue de la République, 93300 Aubervilliers, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Champagne
ICPS Jacques-Cartier, Ramsay générale de santé, 6, avenue du Noyer-Lambert, 91300 Massy, France; Hôpital Claude-Gallien, 91480 Quincy Sous-Senart, France.
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Lefèvre
D001024:Aortic Valve Stenosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects; D016896:Treatment Outcome
Aortic stenosis; Femme; Gender; Genre; Prognosis; Pronostic; Rétrécissement aortique; TAVI; Women