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Carotid access in Transcatheter Aortic Valve Implantation – an alternative to the gold standard. A single-center experience

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Stańska A., Wierzbowska A., Targoński R., Karolak W., Mickiewicz A., Jaguszewski M., Jagielak D.

European Journal of Translational and Clinical Medicine

2019

vol. 2

issue 2

80-84

Background: Transfemoral access is regarded as the TAVI gold standard for the transcatheter aortic valve implantation (TAVI) procedure. However, other options for vascular access have developed in the last few years. Access via the carotid artery is one such alternative. Materials and methods: The study included 9 elderly patients who underwent transcarotid TAVI procedure at the Cardiac and Vascular Surgery Department of the Medical University of Gdańsk. Procedures were performed by a local Heart Team in a hybrid operating room under general anesthesia. Data was collected before the implantation and at discharge. Results: The mean patients’ age was 81 years of age (64-88) and the mean logistic EuroSCORE was 10.8 (7-16). Implantations were performed with 100% device success rate. Intra-operative valve-in-valve procedure was performed in one patient; there were no access-related and valve-related complications during the surgery. Post-procedural complications included minor bleeding, hematoma and pneumothorax. Echocardiographic parameters were significantly improving after the procedure. The mean hospital stay was 5 days (2-7 days). Conclusions: Transcatheter aortic valve implantation via the carotid artery appears to be safe and effective alternative to standard TAVI vascular access.

Carotid access in Transcatheter Aortic Valve Implantation – an alternative to the gold standard. A single-center experience

100%

Stańska A., Wierzbowska A., Targoński R., Karolak W., Mickiewicz A., Jaguszewski M., Jagielak D.

European Journal of Translational and Clinical Medicine

2020

vol. 2

issue 2

80-84

Clinical, biochemical and genetic risk factors for 30-day and 5-year mortality in 518 adult patients subjected to cardiopulmonary bypass during cardiac surgery - the INFLACOR study

84%

Kowalik M., Lango R., Siondalski P., Chmara M., Brzeziński M., Lewandowski K., Jagielak D., Klapkowski A., Rogowski J.

Acta Biochimica Polonica

2018

vol. 65

issue 2

241-250

There is increasing evidence that genetic variability influences patients' early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFLAmmation in Cardiac OpeRations) cohort. In a prospectively recruited cohort of 518 adult Polish Caucasians, who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFα, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their association with 30-day and 5-year mortality. The 30-day mortality was associated with: pre-operative prothrombin international normalized ratio, intra-operative blood lactate, postoperative serum creatine phosphokinase, and acute kidney injury requiring renal replacement therapy (AKI-RRT) in logistic regression. Factors that determined the 5-year survival included: pre-operative NYHA class, history of peripheral artery disease and severe chronic obstructive pulmonary disease, intra-operative blood transfusion; and postoperative peripheral hypothermia, myocardial infarction, infection, and AKI-RRT in Cox regression. Serum levels of IL-6 and ICAM-1 measured three hours after the operation were associated with 30-day and 5-year mortality, respectively. The ICAM1 rs5498 was associated with 30-day and 5-year survival with borderline significance. Different risk factors determined the early (30-day) and late (5-year) survival after adult cardiac surgery in which cardiopulmonary bypass was used. Future genetic association studies in cardiac surgical patients should account for the identified chronic and perioperative risk factors.

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2 European Journal of Translational and Clinical Medicine

1 Acta Biochimica Polonica

2 2020

1 2018

3 Jagielak D.

2 Jaguszewski M.

2 Karolak W.

2 Mickiewicz A.

2 Stańska A.

2 Targoński R.

2 Wierzbowska A.

1 Brzeziński M.

1 Chmara M.

1 Klapkowski A.

1 Kowalik M.

1 Lango R.

1 Lewandowski K.

1 Rogowski J.

1 Siondalski P.

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Carotid access in Transcatheter Aortic Valve Implantation – an alternative to the gold standard. A single-center experience

Carotid access in Transcatheter Aortic Valve Implantation – an alternative to the gold standard. A single-center experience

Clinical, biochemical and genetic risk factors for 30-day and 5-year mortality in 518 adult patients subjected to cardiopulmonary bypass during cardiac surgery - the INFLACOR study