Bibliographic Details
| Title: |
Impact of different guidewires on the implantation depth using the largest self-expandable TAVI device |
| Authors: |
Verena Veulemans, Nihal Wilde, Hendrik Wienemann, Rik Adrichem, Thijmen W. Hokken, Baravan Al-Kassou, Jasmin Shamekhi, Victor Mauri, Oliver Maier, Christian Jung, Patrick Horn, Matti Adam, Georg Nickenig, Stephan Baldus, Nicolas M. Van Mieghem, Malte Kelm, Alexander Sedaghat, Tobias Zeus |
| Source: |
Frontiers in Cardiovascular Medicine, Vol 9 (2023) |
| Publisher Information: |
Frontiers Media S.A., 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
TAVI, elderly, complications, implantation depth, outcome, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: |
BackgroundThe deployment process of the largest self-expandable device (STHV-34) during transcatheter aortic valve implantation (TAVI) might be challenging due to stabilization issues. Whether the use of different TAVI-guidewires impact the procedural success and outcome is not well-known. Therefore, we sought to evaluate the impact of non-Lunderquist (NLu) vs. the Lunderquist (Lu) guidewires during TAVI using the STHV-34 on the procedural and 30-day outcomes.MethodsThe primary study endpoint was defined as the final implantation depth (ID) depending on the selected guidewire strategy. Key secondary endpoints included VARC-3-defined complications.ResultsThe study cohort included 398 patients of four tertiary care institutions, of whom 79.6% (317/398) had undergone TAVI using NLu and 20.4% (81/398) using Lu guidewires. Baseline characteristics did not substantially differ between NLu and Lu patients. The average ID was higher in the Lu cohort (NLu vs. Lu: −5.2 [−7.0–(−3.5)] vs. −4.5 [−6.0–(−3.0)]; p = 0.022*). The optimal ID was reached in 45.0% of patients according to former and only in 20.1% according to nowadays best practice recommendations. There was no impact of the guidewire use on the 30-day outcomes, including conduction disturbances and pacemaker need (NLu vs. Lu: 15.1 vs. 18.5%; p = 0.706).ConclusionThe use of the LunderquistTM guidewire was associated with a higher ID during TAVI with the STHV-34 without measurable benefits in the 30-day course concerning conduction disturbances and associated pacemaker need. Whether using different guidewires might impact the outcome in challenging anatomies should be further investigated in randomized studies under standardized conditions. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2297-055X |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fcvm.2022.1064916/full; https://doaj.org/toc/2297-055X |
| DOI: |
10.3389/fcvm.2022.1064916 |
| Access URL: |
https://doaj.org/article/3f05615dfa4b4771984656d9460c70be |
| Accession Number: |
edsdoj.3f05615dfa4b4771984656d9460c70be |
| Database: |
Directory of Open Access Journals |
