Estudio prospectivo de eventos vasculares periféricos y seguimiento a un mes en pacientes sometidos a implante valvular aórtico transfemoral. Intervenciones de enfermería

Abstract

Introduction and objectives: Transcatheter aortic valve replacement (TAVR) is the best choice for patients for whom surgery has been ruled out. Nowadays, this technique may be performed completely percutaneously, but the physiological consequences of the use of large diameter introducers and the use of vascular closures are still unknown. We present the ƒrst study with both (anatomical and physiological) techniques collected before, during and one month after TAVR. Methods: Between September 2010 and December 2012, 106 patients were consecutively subjected to TAVR at Hospital Clínico San Carlos. 79 patients complied with inclusion criteria and they were included in our observational, cohort, prospective, monocentric, single-blinded study. Only 49 patients completed the follow up. Results: The percutaneous TAVR technique could be successfully performed in all patients. There were no deaths either during the procedure or within 30 days following the TAVR. Complications at the vascular access site occurred in 12 patients (25%), 7 patients (14%) needed a vascular stent to solve some complication. and no patient required urgent surgery. The minimum luminal diameter (mLD) decreased from 6.43+1.2 mm (pre-procedure) to 5.82+1.4 mm (postprocedure) and the minimum luminal area (mLA) decreased from 34+13 mm2 to 28+14 mm2. No statistically signiƒcant changes were found at 1-month follow-up compared with the baseline regarding the non-invasive study of lower limbs. Conclusions: Patients who underwent TAVR present an average loss of 1 mm in the mLA and mLD of the artery wherein a large diameter introducer is inserted. This loss of diameter does not compromise in any way the peripheral vascular "ow.