OBJECTIVES: We intended to show feasibility of sheathless transfemoral aortic valve implantation in patients with small access vessel diameters. BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a valid treatment option in patients with aortic valve stenosis who are poor candidates for surgical aortic valve replacement. Few patients, who cannot undergo transfemoral or transsubclavian aortic valve implantation due to small access vessel diameters, are not suitable for transapical or direct aortic valve implantation, either. METHODS: In more than 700 transcatheter aortic valve implantations since 2008 we identified 17 patients who had to be excluded from transfemoral valve implantation due to vessel diameters <6 mm and who were no candidates for transapical or direct aortic implantation. We performed CoreValve™ implantations in these patients without the required 18F sheath to cross the vessels despite their small size (4.6-5.9 mm). RESULTS: Sixteen sheathless implantations were successful. In all 17 patients, bleeding during the procedure due to the smaller delivery catheter was minimal. Sixteen patients had a successful access site closure at the end of the procedure. CONCLUSIONS: Sheathless implantation of a self-expanding aortic valve can be safely considered in selected patients with access vessel diameters below 6 mm, if transapical or direct aortic implantation is not suitable.
OBJECTIVES: We intended to show feasibility of sheathless transfemoral aortic valve implantation in patients with small access vessel diameters. BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a valid treatment option in patients with aortic valve stenosis who are poor candidates for surgical aortic valve replacement. Few patients, who cannot undergo transfemoral or transsubclavian aortic valve implantation due to small access vessel diameters, are not suitable for transapical or direct aortic valve implantation, either. METHODS: In more than 700 transcatheter aortic valve implantations since 2008 we identified 17 patients who had to be excluded from transfemoral valve implantation due to vessel diameters <6 mm and who were no candidates for transapical or direct aortic implantation. We performed CoreValve™ implantations in these patients without the required 18F sheath to cross the vessels despite their small size (4.6-5.9 mm). RESULTS: Sixteen sheathless implantations were successful. In all 17 patients, bleeding during the procedure due to the smaller delivery catheter was minimal. Sixteen patients had a successful access site closure at the end of the procedure. CONCLUSIONS: Sheathless implantation of a self-expanding aortic valve can be safely considered in selected patients with access vessel diameters below 6 mm, if transapical or direct aortic implantation is not suitable.
Authors: Alexander Sedaghat; Jan-Malte Sinning; Mariuca Vasa-Nicotera; Alexander Ghanem; Christoph Hammerstingl; Eberhard Grube; Georg Nickenig; Nikos Werner Journal: Clin Res Cardiol Date: 2013-07-23 Impact factor: 5.460
Authors: Susheel K Kodali; Mathew R Williams; Craig R Smith; Lars G Svensson; John G Webb; Raj R Makkar; Gregory P Fontana; Todd M Dewey; Vinod H Thourani; Augusto D Pichard; Michael Fischbein; Wilson Y Szeto; Scott Lim; Kevin L Greason; Paul S Teirstein; S Chris Malaisrie; Pamela S Douglas; Rebecca T Hahn; Brian Whisenant; Alan Zajarias; Duolao Wang; Jodi J Akin; William N Anderson; Martin B Leon Journal: N Engl J Med Date: 2012-03-26 Impact factor: 91.245
Authors: A Pieter Kappetein; Stuart J Head; Philippe Généreux; Nicolo Piazza; Nicolas M van Mieghem; Eugene H Blackstone; Thomas G Brott; David J Cohen; Donald E Cutlip; Gerrit-Anne van Es; Rebecca T Hahn; Ajay J Kirtane; Mitchell W Krucoff; Susheel Kodali; Michael J Mack; Roxana Mehran; Josep Rodés-Cabau; Pascal Vranckx; John G Webb; Stephan Windecker; Patrick W Serruys; Martin B Leon Journal: Eur Heart J Date: 2012-10 Impact factor: 29.983
Authors: Emmanuel Chorianopoulos; Ulrike Krumsdorf; Nicolas Geis; Sven T Pleger; Evangelos Giannitsis; Hugo A Katus; Raffi Bekeredjian Journal: Clin Res Cardiol Date: 2013-10-06 Impact factor: 5.460
Authors: Nicolo Piazza; Bindu Kalesan; Nicolas van Mieghem; Stuart Head; Peter Wenaweser; Thierry P Carrel; Sabine Bleiziffer; Peter P de Jaegere; Brigitta Gahl; Robert H Anderson; Arie-Pieter Kappetein; Ruediger Lange; Patrick W Serruys; Stephan Windecker; Peter Jüni Journal: JACC Cardiovasc Interv Date: 2013-05 Impact factor: 11.195
Authors: Stefan Stortecky; Valerie Schmid; Stephan Windecker; Alexander Kadner; Thomas Pilgrim; Lutz Buellesfeld; Ahmed A Khattab; Peter Wenaweser Journal: EuroIntervention Date: 2012-08 Impact factor: 6.534