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Transaxillary transcatheter aortic valve implantation utilizing a novel vascular closure device with resorbable collagen material: a feasibility study

  • Andreas Schaefer
  • Johannes Schirmer
  • Niklas Schofer
  • Yvonne Schneeberger
  • Florian Deuschl
  • Stefan Blankenberg
  • Hermann Reichenspurner
  • Lenard Conradi
  • Ulrich Schäfer
Original Paper
  • 151 Downloads

Abstract

Objectives

We herein aimed to evaluate technical feasibility of transaxillary (Tax) transcatheter aortic valve implantation (TAVI) utilizing a novel vascular closure device with a resorbable collagen plug and absence of suture material.

Methods

Between 05/2018 and 8/2018, eight patients (76.0 ± 5.9 years, 62.5% male, logEuroSCORE I 23.6 ± 4.7) received Tax-TAVI using the MANTA™ vascular closure device. Implanted transcatheter heart valves consisted of Edwards Sapien 3, NVT Allegra, Medtronic CoreValve EvolutR and SJM Portico.

Results

Puncture location depth was variable (3.5–7.5 cm). The left subclavian artery was used in five cases, the right subclavian artery in three cases. Low-pressure balloon-angioplasty for vessel closure was performed in 5/8 patients. VARC-2 defined device success was met in all patients. Major access site complication occurred in one patient with aneurysma spurium of the subclavian artery and consecutive stent implantation on postoperative day 5.

Conclusion

The MANTA™ device is applicable in Tax-TAVI, with potential particular advantages regarding easiness of use and marked access for subsequent interventions in case of vascular complications. Before conclusions regarding clinical efficacy and safety can be made, the device has to be evaluated in larger patient cohorts.

Keywords

Transcatheter aortic valve implantation Transaxillary Vascular closure device 

Abbreviations

TA

Transapical

TAVI

Transcatheter aortic valve implantation

Tax

Transaxillary

TF

Transfemoral

THV

Transcatheter heart valve

Notes

Compliance with ethical standards

Conflict of interest

A. Schaefer received travel compensation from Symetis SA and Abbott Vascular Inc. L. Conradi is a Proctor for Symetis SA and Edwards Lifesciences Inc. and received travel support and lecture fees from Abbott Vascular Inc., Edwards Lifescieences Inc., Boston Scientific Co. and Medtronic PLC. U. Schäfer is a Proctor for Symetis SA, Medtronic, Bostons Sci, Edwards Lifesciences Inc.; New Valve Technology, Abbott Vascular, and received travel support and lecture fees from Symetis SA, Medtronic, Bostons Sci, Edwards Lifesciences Inc.; New Valve Technology, Abbott Vascular.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Andreas Schaefer
    • 1
  • Johannes Schirmer
    • 1
  • Niklas Schofer
    • 2
  • Yvonne Schneeberger
    • 1
  • Florian Deuschl
    • 2
  • Stefan Blankenberg
    • 2
  • Hermann Reichenspurner
    • 1
  • Lenard Conradi
    • 1
  • Ulrich Schäfer
    • 2
  1. 1.Department of Cardiovascular SurgeryUniversity Heart Center HamburgHamburgGermany
  2. 2.Department of General and Interventional CardiologyUniversity Heart Center HamburgHamburgGermany

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