• Anna Pyłko, Maciej Dąbrowski, Ilona Kowalik, Zbigniew Chmielak, Krzysztof Kukuła, Rafał Wolny, Jacek Kwieciński, Patrycjusz Stokłosa, Maciej Grabowski, Ilona Michałowska, Krzysztof Kuśmierski, and Adam Witkowski.
• Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
• Pol. Arch. Med. Wewn. 2024 Apr 26; 134 (4).

IntroductionTransfemoral access is a prevailing approach for transcatheter aortic valve implantation (TAVI) in contemporary practice, with a shift from surgical arteriotomy to a percutaneous arterial approach.ObjectivesThis study assessed long- and short‑term mortality, along with Valve Academic Research Consortium-2-defined complications in percutaneous transfemoral approach (PTA) TAVI. Furthermore, it explored the impact of a learning curve on procedural outcomes.Patients And MethodsThe study included 600 patients undergoing PTA TAVI at the National Institute of Cardiology, Warsaw, Poland, from January 2009 to September 2020. Retrospective data comparison involved 2 groups: early experience (first 200 patients) and late experience (next 400 patients).ResultsThe primary end point (composite of life‑threatening bleeding, major vascular complication, or death at 30 days) occurred less often in the late experience group (28% vs 17.5%; P = 0.003). The late experience group also showed fewer cases of vascular complications (19% vs 10.7%; P = 0.005) and major bleeding (17.5% vs 8.5%; P = 0.001). Propensity matching yielded similar trends, including reduced frequency of pacemaker implantation (22.8% vs 10.9%; P = 0.03) and shorter median (interquartile range) hospitalization (11 [8-18] vs 7 [6-12] days; P <0.001) in the late experience group.ConclusionsThe late experience group rated with PTA TAVI exhibited significantly reduced periprocedural complications, indicating a positive impact of accumulated expertise.

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