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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Published on: December 11, 2017

A modified "preclosure" technique after percutaneous aortic valve replacement.

Philipp Kahlert1, Holger Eggebrecht, Raimund Erbel

  • 1West German Heart Center Essen, Department of Cardiology, University Duisburg-Essen, Germany. Philipp.Kahlert@uk-essen.de

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 14, 2008
PubMed
Summary
This summary is machine-generated.

A modified preclosure technique using suture-mediated devices is feasible and safe for managing femoral artery access after percutaneous aortic valve replacement (PAVR). This approach improves procedural management and reduces the need for general anesthesia.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Percutaneous aortic valve replacement (PAVR) offers an endovascular alternative to open surgery for high-risk patients.
  • Large-bore femoral artery access is necessary for PAVR, often requiring surgical closure and general anesthesia.
  • A percutaneous closure method would simplify procedures and reduce the need for surgery and general anesthesia.

Purpose of the Study:

  • To assess the feasibility, safety, and efficacy of suture-mediated closure devices with a modified "preclosure" technique.
  • To evaluate this technique for managing access sites after percutaneous aortic valve replacement (PAVR).

Main Methods:

  • Direct puncture of the common femoral artery was performed.
  • Three conventional suture-mediated closure devices (6F Perclose) were deployed.
  • Sutures were tied post-procedure; additional devices were used if hemostasis was not achieved.

Main Results:

  • Percutaneous closure was successful in all 15 PAVR patients, allowing conscious sedation in most.
  • Complications included one retroperitoneal bleed and two artery dissections (femoral/iliac).
  • Vascular surgery was needed only for total vessel occlusion post-suture closure; all patients recovered.

Conclusions:

  • The modified "preclosure" technique is a feasible and safe method for hemostasis after PAVR.
  • This technique enhances procedural management and decreases the requirement for general anesthesia.
  • Suture-mediated closure offers a promising percutaneous alternative for PAVR access site management.