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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorAlperi, Alberto
dc.contributor.authorMcInerney, Angela
dc.contributor.authorModine, Thomas
dc.contributor.authorChamandi, Chekrallah
dc.contributor.authorTafur Soto, Jose
dc.contributor.authorBarbanti, Marco
dc.contributor.authorSerra García, Vicente
dc.date.accessioned2022-09-09T14:54:10Z
dc.date.available2022-09-09T14:54:10Z
dc.date.issued2022-06
dc.identifier.citationAlperi A, Mcinerney A, Modine T, Chamandi C, Tafur-Soto JD, Barbanti M, et al. Transcatheter aortic valve replacement in obese patients: procedural vascular complications with the trans-femoral and trans-carotid access routes. Interact Cardiovasc Thorac Surg. 2022 Jun;34(6):982–9.
dc.identifier.issn1569-9285
dc.identifier.urihttp://hdl.handle.net/11351/8132
dc.descriptionObesity; Transcarotid; Transfemoral
dc.description.abstractOBJECTIVES Obesity may increase the risk of vascular complications in transfemoral (TF) transcatheter aortic valve replacement (TAVR) procedures. The transcarotid (TC) approach has recently emerged as an alternative access in TAVR. We sought to compare vascular complications and early clinical outcomes in obese patients undergoing TAVR either by TF or TC vascular access. METHODS Multicentre registry including obese patients undergoing TF- or TC-TAVR in 15 tertiary centres. All patients received newer-generation transcatheter heart valves. For patients exhibiting unfavourable ileo-femoral anatomic characteristics, the TC approach was favoured in 3 centres with experience with it. A propensity score analysis was performed for overcoming unbalanced baseline covariates. The primary end point was the occurrence of in-hospital vascular complications (Valve Academic Research Consortium-2 criteria). RESULTS A total of 539 patients were included, 454 (84.2%) and 85 (15.8%) had a TF and TC access, respectively. In the propensity-adjusted cohort (TF: 442 patients; TC: 85 patients), both baseline and procedural valve-related characteristics were well-balanced between groups. A significant decrease in vascular complications was observed in the TC group (3.5% vs 12% in the TF group, odds ratio: 0.26, 95% CI: 0.07–0.95, P = 0.037). There were no statistically significant differences between groups regarding in-hospital mortality (TC: 2.8%, TF: 1.5%), stroke (TC: 1.2%, TF: 0.4%) and life-threatening/major bleeding events (TC: 2.8%, TF: 3.8%). CONCLUSIONS In patients with obesity undergoing TAVR with newer-generation devices, the TC access was associated with a lower rate of vascular complications. Larger randomized studies are warranted to further assess the better approach for TAVR in obese patients.
dc.language.isoeng
dc.publisherOxford University Press
dc.relation.ispartofseriesInteractive CardioVascular and Thoracic Surgery;34(6)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectVàlvula aòrtica - Estenosi - Cirurgia
dc.subjectPersones obeses
dc.subjectCateterisme cardíac - Complicacions
dc.subject.meshTranscatheter Aortic Valve Replacement
dc.subject.mesh/adverse effects
dc.subject.meshObesity
dc.subject.meshAortic Valve Stenosis
dc.titleTranscatheter aortic valve replacement in obese patients: procedural vascular complications with the trans-femoral and trans-carotid access routes
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1093/icvts/ivab354
dc.subject.decssustitución valvular aórtica con catéter
dc.subject.decs/efectos adversos
dc.subject.decsobesidad
dc.subject.decsestenosis de la válvula aórtica
dc.relation.publishversionhttps://doi.org/10.1093/icvts/ivab354
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Alperi A] Quebec Heart & Lung Institute, Laval University, Quebec City, Canada. [McInerney A] Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Spain. [Modine T] Centre Hospitalier Universitaire de Lille, Lille, France. [Chamandi C] Hôpital européen Georges-Pompidou, Paris, France. [Tafur-Soto JD] The Ochsner Clinical School, Ochsner Medical Center, New Orleans, LA, USA. [Barbanti M] Ferrarotto Hospital, University of Catania, Catania, Italy. [Serra V] Vall d’Hebron Hospital Universitari, Barcelona, Spain
dc.identifier.pmid34942005
dc.identifier.wos000756825900001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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