Document Detail


Percutaneous suture closure for management of large French size arterial puncture in aortic valvuloplasty.
MedLine Citation:
PMID:  11481509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Percutaneous aortic valvuloplasty produces acute hemodynamic and clinical improvement in patients with aortic stenosis who are poor candidates for surgical valve replacement. The benefits of this procedure are mitigated by the high restenosis rates and 1--2 year mortality, in addition to significant vascular complications associated with the large arterial puncture necessary for retrograde arterial approaches. We describe the use of suture closure techniques to reduce the vascular morbidity associated with this procedure. We reviewed 31 consecutive patients who underwent percutaneous aortic valvuloplasty and suture closure with the Perclose device between April 1998 and September 2000. After diagnostic catheterization using 6--8 French (Fr) sheaths, an 8 or 10 Fr Perclose device was preloaded into the artery and the untied sutures left in place. A 12.5 or 14 Fr sheath was passed over the wire, through the sutures. The sutures were tied at the conclusion of the procedure, in conjunction with sheath removal. Twenty-seven out of 31 patients (87%) had successful suture closure of the arteriotomy and did not require prolonged bed rest, manual compression or a compression device. There were 4 failures of percutaneous suture closure, requiring conventional manual compression and bed rest for hemostasis. No patient required surgical repair of the arteriotomy, nor were there any limb complications. Compared to 39 consecutive prior patients who had their arterial puncture managed with manual compression, length of stay was shorter (2.2 days versus 5.3 days) and fewer patients received blood transfusions (0% versus 29%). Preloaded suture closure of the arterial puncture is a useful technique for achieving hemostasis after removal of the large sheaths used for percutaneous valvuloplasty, and reduces the post-procedure patient discomfort and prolonged bed rest associated with this procedure.
Authors:
L W Solomon; B Fusman; N Jolly; A Kim; T Feldman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  13     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-01     Completed Date:  2001-09-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-6     Citation Subset:  IM    
Affiliation:
University of Chicago Hospitals, Hans Hecht Hemodynamics Laboratory, Pritzker School of Medicine, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / therapy*
Balloon Dilatation*
Female
Femoral Artery
Humans
Male
Punctures*
Suture Techniques* / instrumentation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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