Details

Autor(en) / Beteiligte

• Veulemans, Verena
• Wilde, Nihal
• Wienemann, Hendrik
• Adrichem, Rik
• Hokken, Thijmen W
• Al-Kassou, Baravan
• Shamekhi, Jasmin
• Mauri, Victor
• Maier, Oliver
• Jung, Christian
• Horn, Patrick
• Adam, Matti
• Nickenig, Georg
• Baldus, Stephan
• Van Mieghem, Nicolas M
• Kelm, Malte
• Sedaghat, Alexander
• Zeus, Tobias

Titel

Impact of different guidewires on the implantation depth using the largest self-expandable TAVI device

Ist Teil von

• Frontiers in cardiovascular medicine, 2023-01, Vol.9, p.1064916-1064916

Ort / Verlag

Switzerland: Frontiers Media S.A

Erscheinungsjahr

2023

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• The 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. The 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. The 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)]; = 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%; = 0.706). The use of the Lunderquist 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.