Percutaneous femoral artery access with Prostar device for innovative mitral and aortic interventions

The potential advantages of percutaneous femoral access over a surgical approach are easier recovery and lower inguinal complications rate. This technique can be an asset in disabled patients with high risk of decubitus complications or in surgically challenging patients (obesity). We describe percutaneous access for mitral and aortic minimally invasive valvular interventions in 156 patients (transcatheter aortic valve implantation, n = 40; and minimally invasive cardiac surgery, n = 116). Severe complications, in two transcatheter aortic valve implantation (TAVI) patients (one retroperitoneal bleeding and one massive superficial bleeding) and in three minimally invasive patients (two retroperitoneal bleeding and one arteriovenous fistula), occurred duringfirst 50 patients versus 0 among 106 following patients (p = 0.01). Percutaneous access is possiblefor innovativecardiac interventions, but severe complications can occur, especially duringthe learning curve,with seriousconsequences in high operative risk patients, urging highest caution when initiating this innovative approach. # 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.