Single-center study of combined application of ExoSeal vascular closure device after two ProGlide sutures failed in transcatheter aortic valve replacement
10.3969/j.issn.1004-8812.2024.06.008
- VernacularTitle:经导管主动脉瓣置换术预留两把ProGlide缝合失败后联合应用ExoSeal血管闭合器的单中心研究
- Author:
Shuo WANG
1
;
Qing-Hou ZHENG
;
Hong-Song ZHANG
;
Le WANG
;
Jie MI
;
Liu LI
Author Information
1. 河北医科大学第一医院心内科,河北石家庄 050011;石家庄市人民医院心内科,河北石家庄 050031
- Keywords:
ExoSeal vascular closure device;
Transcatheter aortic valve replacement;
Femoral artery complications
- From:
Chinese Journal of Interventional Cardiology
2024;32(6):338-342
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study was to evaluate the application effect of ExoSeal vascular closure device in patients with failed ProGlide suturing after transcatheter aortic valve replacement.Methods Retrospective analysis of 35 patients who underwent TAVR surgery at the Heart Center of the First Hospital of Hebei Medical University from May 2020 to January 2024 and experienced failure in suturing with two ProGlide sutures,and subsequently underwent combined application of the ExoSeal vascular closure device.The efficacy of the ExoSeal vascular closure device was summarized,and the patients'postoperative hemostasis time,manual compression time,lower limb immobilization time,elastic bandage compression time,bleeding volume during compression,postoperative femoral artery complications,and femoral artery ultrasound were observed.The efficacy of the ExoSeal vascular closure device in patients undergoing transcatheter aortic valve replacement was evaluated through the above indicators.Results(1)Postoperative Hemostatic Effect:The time for postoperative hemostasis through the femoral artery was(6.89±2.66)min,the manual compression time was(4.65±1.33)min,the elastic bandage compression time was(3.79±1.57)h,the lower limb immobilization time was(13.74±5.51)h,and the amount of bleeding during compression was(12.74±3.61)g.(2)Complications of the femoral artery:The success rate of hemostasis was 85.7％;there were 4 cases of local bleeding and hematoma requiring hemostasis(11.4％);there was 1 case of pseudoaneurysm,arteriovenous fistula,vascular laceration or retroperitoneal bleeding(2.8％);there were no ipsilateral vascular insufficiency or embolic manifestations,puncture site infection,related nerve injury,surgical or non-surgical techniques for repairing blood vessels.(3)Preoperative and postoperative ultrasound of the femoral artery:There was no significant difference in the average diameter of the common femoral artery and the peak systolic flow velocity of the common femoral artery(both P＞0.05).Conclusions The application of the ExoSeal vascular closure device in patients with failed ProGlide suturing during transcatheter aortic valve replacement is safe and effective.
