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Vascular complications after balloon aortic valvuloplasty in recent years: Incidence and comparison of two hemostatic devices
Author(s) -
Dall'Ara Gianni,
Santarelli Andrea,
Marzocchi Antonio,
Bacchi Reggiani Maria Letizia,
Sabattini Maria Rita,
Moretti Carolina,
Marrozzini Cinzia,
Taglieri Nevio,
Baldazzi Federica,
Franco Nicoletta,
Ortolani Paolo,
Chiarabelli Matteo,
Rodinò Giulio,
Piovaccari Giancarlo,
Rapezzi Claudio,
Saia Francesco
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27328
Subject(s) - medicine , aortic valvuloplasty , incidence (geometry) , cardiology , vascular closure device , myocardial infarction , stroke (engine) , adverse effect , balloon , surgery , hemostasis , aortic valve , aortic valve stenosis , mechanical engineering , physics , optics , engineering
Objectives To define the incidence of vascular complications (VC) after balloon aortic valvuloplasty (BAV) in recent years, and to compare the performance of two vascular closure devices (VCD). Background VC remain the most frequent drawback of BAV and are associated with adverse clinical outcomes. Methods All BAV procedures performed at 2 high‐volume centers over a 6‐year period ( n = 930) were collected in prospective registries and investigated to assess the incidence of Valve Academic Research Consortium‐2 (VARC‐2) defined VC. Incidence of life‐threatening, major and minor bleeding was also assessed. In‐hospital major adverse cardiac and cerebrovascular events (MACCE) rate (composite of in‐hospital death, myocardial infarction, TIA/stroke, and life‐threatening bleeding) as well as 30‐day survival was compared between a suture‐mediated closure system and a collagen plug hemostatic device. Results A 9 Fr arterial sheath was used in most of the patients (84.1%). Vascular closure was obtained with the Angio‐Seal in 643 patients (69.1%) and the ProGlide in 287 (30.9%). The overall incidence of major VC was 2.7%, and minor VC 6.6%, without significant differences between groups. The Angio‐Seal group was associated with a higher rate of small hematomas (6.9% vs. 3.5%, P = 0.042), whilst blood transfusions were more frequent in the ProGlide group (6.6% vs. 3.5%, P = 0.034). Rates of in‐hospital MACCE and 30‐day survival were similar. Use of either VCD was not independently associated with major VC. Conclusions VC rate after BAV is fairly low in experienced centers without major differences between the 2 most used VCD.