Percutaneous femoral artery access with Prostar device for innovative mitral and aortic interventions

The potential advantages of percutaneous femoral access over a surgical approach are easier recovery and lower inguinal complications rate. This technique can be an asset in disabled patients with high risk of decubitus complications or in surgically challenging patients (obesity). We describe percutaneous access for mitral and aortic minimally invasive valvular interventions in 156 patients (transcatheter aortic valve implantation, n=40; and minimally invasive cardiac surgery, n=116). Severe complications, in two transcatheter aortic valve implantation (TAVI) patients (one retroperitoneal bleeding and one massive superficial bleeding) and in three minimally invasive patients (two retroperitoneal bleeding and one arteriovenous fistula), occurred during first 50 patients versus 0 among 106 following patients (p=0.01). Percutaneous access is possible for innovative cardiac interventions, but severe complications can occur, especially during the learning curve, with serious consequences in high operative risk patients, urging highest caution when initiating this innovative approach.