Author + information
- Radoslaw Parma1,
- Maciej Dabrowski2,
- Zofia Parma1,
- Didier Tchetche3,
- Stephan Kische4,
- Adam Witkowski2 and
- Wojtek Wojakowski5
Diameters of sheaths used for transcatheter aortic valve replacement (TAVR) are related to vascular complication and bleeding rates. Currently, TAVR sheath labels represent their nominal inner diameter. Data on outer diameters of TAVR sheaths and their changes are missing. Aims of the study were: 1. to examine the outer diameter (OD) of femoral sheaths used in TAVR 2. to detect their changes during the passage of TAVR delivery systems 3. to compare sheath ODs with respective recommended artery sizes
We studied 14 different types of TAVR sheaths. Their ODs were examined using a certified calliper. OD measurements were performed from the tip to the proximal sheath end with a 10 mm interval. They were repeated before (initial OD) and after the passage (final OD) of dedicated TAVR delivery systems in 5 samples of each TAVR sheath type.
Initial OD ranged from 4.64 mm (SoloPath Expandable) to 7.95 mm (Lotus Large). The final OD ranged from 6.90 mm (Gore DrySeal) to 8.68 mm (Solopath Recollapsible 19F). 4 expandable sheath diameters increased significantly after TAVR system passage: Edwards eSheath 16F by 19%, eSheath 14F 23%, Solopath Expandable 19F 64%, Solopath Recollapsible 19F 72% (figure).
Initial outer diameters of femoral sheaths currently used in TAVR range from 4.64 to 7.95 mm. Their final diameters range from 6.9 to 8.68 mm. Outer diameters differ between sheaths of the same inner diameter. Expandable sheaths feature the smallest initial outer diameter, yet the large extent of their expansion in the arterial entry site and their narrowed segments may impact this safety advantage.
STRUCTURAL: Valvular Disease: Aortic