Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598957
e-Poster Presentations
Tuesday, February 14th, 2017
DGTHG: e-Poster: Catheter-based Heart Valve Techniques
Georg Thieme Verlag KG Stuttgart · New York

Prior Prosthetic Hip Replacement Is Related to Different Outcomes of Transapical versus Transfemoral Transcatheter Aortic Valve Implantation

J. Köhne
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
,
M. Doss
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
,
A. Van Linden
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
,
M. Arsalan
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
,
T. Holubec
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
,
W.K. Kim
2   Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany
,
C. Liebetrau
2   Kerckhoff Klinik, Kardiologie, Bad Nauheim, Germany
,
T. Walther
1   Kerckhoff Klinik, Herzchirurgie, Bad Nauheim, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

   All articles of this category

Objective: Hip replacement prior to transcatheter aortic valve implantation (TAVI) was associated with worse outcomes compared with patients who did not have prior hip replacement (PHR). Aim of the study was to evaluate whether worse outcomes were related to the access route or to frailty of the patients in general.

Methods and Results: Retrospective single center analysis of 100 patients who underwent TAVI between July 2012 and May 2015 and had PHR. Amongst those 100 patients the transapical (TA) approach was used in 50 patients and the transfemoral (TF) approach in 50 patients. TA or TF access suitability was assessed based on 3mensio analysis of pre-OP CT data and vascular complications were defined according to VARC II criteria. Follow-up was performed up to 1 year.

Patient mean age was 82± 7 years (TA) and 80± 5 years (TF). 66% of the patients were female. Logistic EuroSCORE I was 25.9%±14.2 (TA) and 24.7% ±11.0 (TF), p = n.s. STS score was 7.1% ± 4.8 (TA) versus 5.7% ± 3 (TF), p = 0.661.

Vascular complications occurred 0% (TA) versus 8% (TF), p = 0.117; conversion rate (to either TA access or sternotomy) was 0% (TA) versus 4% (TF), p = 0.495. Major stroke occurred in 2% (TA) versus 6% (TF), p = 0.617. New onset pacemaker implantation was required in 15% (TA) versus 20% (TF), p = 0.424.

The in-hospital mortality was 10% (n = 5) in both groups (p = n.s.), 30-day mortality was 14% (TA) and 12% (TF), p = 0.766. One-year mortality was 18% (TA) and 12% (TF), p = n.s.

Conclusion: Patients with prior hip replacement comprise a rather sick and higher risk TAVI population. This study shows that hip replacement prior to TAVI is associated with worse outcomes regarding vascular access in TF patients. Mortality is comparable between both groups; however, the outcome is worse compared with patients without PHR.

Keywords: TAVI, prosthetic hip replacement, access, vascular complications, mortality