Use of a percutaneous arterial suture device (Perclose) in patients undergoing percutaneous balloon aortic valvuloplasty

Percutaneous balloon aortic valvuloplasty has been used as a therapeutic op tion for patients with severe aortic stenosis who are not candidates for ao rtic valve replacement. This procedure has been limited by both the high ra te of aortic valve restenosis and high procedural morbidity related chiefly to the large femoral arteriotomies required. The purpose of this study was to assess the feasibility and vascular complication rate using the "Preclo se" technique in patients undergoing balloon aortic valvuloplasty. We evalu ated the immediate and 30-day results in 18 consecutive patients undergoing this procedure. Angiographically significant peripheral vascular disease w as present in 39% of cases. Aortic balloon dilation produced significant de creases in the mean aortic valve pressure gradient from 55 +/- 20 mmHg to 3 0 +/- 22 mmHg (P < 0.001). Closure of the arteriotomy with an 8F (10F in 1 case) Perclose device led to immediate hemostasis in all patients. Perclose of the contralateral femoral arterial site with a 6F device was attempted in 50%, all of which were successful. The mean length of bed rest was 4.5 /- 0.9 hr. No procedural was observed. No patient had a local vascular comp lication, and no patient required blood product transfusion after the proce dure. The use of the "Preclose" technique for closure of femoral arteriotom ies after balloon aortic valvuloplasty is feasible and associated with a lo w rate of periprocedural and short-term vascular complications. (C) 2001 Wi ley-Liss, Inc.