Vascular Complications in Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Vascular complications (VCs) are a significant concern following transcatheter aortic valve replacement (TAVR).
• Limited data exist on VCs with newer generation TAVR devices.

Purpose of the Study:

• To determine the incidence, management, predictors, and clinical impact of VCs in patients undergoing TAVR with contemporary devices.

Main Methods:

• A multicenter study involving 8815 patients who underwent transfemoral TAVR.
• VCs were classified using Valve Academic Research Consortium-3 criteria.
• Data were collected prospectively in a dedicated database.

Main Results:

• VCs occurred in 16.5% of patients, predominantly access-related (87%).
• Major VCs were linked to increased 1-year mortality (HR 2.33), while minor VCs were not.
• Female sex, DAPT, anatomical factors, and large closure devices increased major VC risk; echocardiography-guided and radial access were protective.

Conclusions:

• VCs remain a significant issue in contemporary TAVR, influenced by modifiable factors.
• Major VCs negatively impact survival, underscoring the importance of minimizing their occurrence.
• Preventing VCs after TAVR is crucial for improving patient outcomes.