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Updated: Apr 29, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Initial experience of two national centers in transcatheter aortic prosthesis implantation
Sebastián Lluberas1, Alexandre Abizaid1, Dimytri Siqueira1
1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Background:
Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.
Objectives:
To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.
Methods:
From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.
Results:
Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly.
Conclusions:
Transcatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.
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