Impact of sheath diameter of different sheath types on vascular complications and mortality in transfemoral TAVI approaches using the Proglide closure device

• Published in: PloS one Vol. 12; no. 8; p. e0183658
• Main Authors: Dimitriadis, Zisis, Scholtz, Werner, Ensminger, Stephan M., Piper, Cornelia, Bitter, Thomas, Wiemer, Marcus, Vlachojannis, Marios, Börgermann, Jochen, Faber, Lothar, Horstkotte, Dieter, Gummert, Jan, Scholtz, Smita
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.08.2017; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Analysis; Anesthesia; Aorta; Aortic valve; Aortic Valve - surgery; Aortic valve stenosis; Biology and Life Sciences; Body mass; Care and treatment; Catheters; Complications; Direct flow; Dosage and administration; Electrocardiography; Female; Femoral Artery - surgery; Heart Valve Prosthesis Implantation - methods; Humans; Implantation; Incidence; Male; Medicine and Health Sciences; Mortality; Patients; Physical Sciences; Research and Analysis Methods; Risk factors; Sheaths; Surgeons; Surgery; United States > US; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183658

Evaluation of the impact of the sheath diameter on vascular complications and mortality in transfemoral aortic valve implantation. Between 2012 and 2014, 183 patients underwent the procedure using a sheath diameter of 18-24 F. This collective was divided into two groups: group 1, with a sheath diameter of 18F (G1, n = 94), consisted of patients with 18F Medtronic Sentrant and 18 F Direct Flow sheaths, and group 2 with a sheath diameter of 19-24 F (G2, n = 89) consisted of patients with Edwards expandable e-sheath and Solopath sheaths. Perclose-Proglide® was used as a closure device in all patients. G1 had significantly more female patients (64.9% vs. 46.1% in G2, p = 0.01) and the average BMI was lower (26 ± 4.5% vs. 27.4 ± 4.7%, p = 0.03). There was no significant difference in the incidence of major and minor vascular complications (G1: 12.8% vs. G2: 12.4%, p = 0.9). 30-day mortality was similar in both groups (G1: 6.4 ± 2.5% [95% CI: 0.88-0.98], G2: 3.7 ± 1.9% [95% CI: 0.92-0.99]. The Kaplan Meier analysis of survival revealed no significant differences either. The difference in sheath diameter had no effect on either incidence or severity of vascular complications. There was no impact on mortality either.