Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Lukasz Kmiec; Matthaeus Zerdzitzki; Christof Schmid; Kurt Debl; Samuel Sossalla; Michael Hilker; Andreas Holzamer

doi:10.1055/s-0041-1730972

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2023; 71(02): 084-093
DOI: 10.1055/s-0041-1730972

Original Cardiovascular

Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI

Authors

Lukasz Kmiec

¹Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
Matthaeus Zerdzitzki

¹Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
Christof Schmid

¹Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
Kurt Debl

²Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
Samuel Sossalla

²Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
Michael Hilker

¹Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
Andreas Holzamer

¹Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany

Abstract

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Abstract

Background The MANTA vascular closure device (VCD) is a novel collagen plug-based VCD for large bore arteriotomies. The current literature regarding complication rates of this device is quite variable and mostly limited to relatively small case series.

Methods This study is retrospective analysis of the MANTA VCD-related main access site complications according to Valve Academic Research Consortium-2 (VARC-2) criteria during the hospital stay. Particular attention was paid to the detailed analysis of multislice computed tomography with regard to the anatomy of the access vessel and the puncture site itself.

Results A total of 524 patients underwent transfemoral transcatheter aortic valve implantation (TF TAVI) including the use of the MANTA device (18F) for percutaneous vascular closure. A group of 22 patients was excluded from the study due to incomplete imaging data. During the study period, we observed 28 major (5.6%) and five minor (1.0%) MANTA device-related vascular complications. There was no patient death related to these adverse events. Female gender, vessel angulation at the puncture site, and at least moderate calcification of the dorsal vessel segment were identified as independent predictors for major complications.

Conclusions The MANTA device is a feasible option for vascular closure of large bore arteriotomies in patients undergoing TF TAVI or other percutaneous transfemoral interventions. Furthermore, we have identified novel predictors for device failure/complications that should be taken into account for selection of the appropriate closure device. To our knowledge, this report is one of the largest case series analyzing the use of the MANTA VCD.

Keyword

aortic valve - transfemoral - percutaneous - outcome - TAVI - complications - artery/arteries

Full Text

References

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