{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T22:09:46Z","timestamp":1761948586846,"version":"3.40.5"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the safety of utilizing transapical access during structural interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Complex interventions of the mitral or aortic region sometimes require coaxial forces to orient and deliver devices. Apical access can provide coaxial countertraction for either transseptal or retrograde aortic access. This manuscript describes the single center experience of small bore transapical access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of cases from 2013 to 2018 at Henry Ford Hospital was performed. Patient demographics and procedure characteristics were abstracted to describe the safety of transapical access using small bore sheaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total 21 cases were performed at Henry Ford, most of them for transcatheter mitral valve replacement (81%). The mean sheath size used was 4.7\u2009\u00b1\u20090.9 Fr and protamine was used at the end of 57% of cases. All patients received nitinol\u2010based plugs, 80.1% were from the Amplatz Duct Occluder II type. Four major complications related apical puncture occurred, two pericardial effusions, two hemothorax. Over a median follow time of 430\u2009days (IQR 50\u2013652) a total of five deaths occurred, two related to the procedure and three late deaths with a median time of 362\u2009days (range 205\u2013628\u2009days). No deaths were associated with transapical access. Echocardiographic follow up did not detect any late structural complications from occluder devices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transapical access and closure with nitinol\u2010based devices is feasible and facilitates complex interventions where coaxial forces are need for device delivery and alignment. The most common complication is bleeding and this should be kept in perspective when treating high\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28731","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T12:21:15Z","timestamp":1579522875000},"page":"481-487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Complete percutaneous apical access and closure: Short and intermediate term outcomes"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-6504","authenticated-orcid":false,"given":"Marvin H.","family":"Eng","sequence":"first","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riyad Yazan","family":"Kherallah","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-8096","authenticated-orcid":false,"given":"Mayra","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam B.","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Emory University  Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberio","family":"Frisoli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9924","authenticated-orcid":false,"given":"Dee Dee","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Wyman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Structural Heart Disease Henry Ford Hospital  Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","first-page":"Iii80","article-title":"Cooperative study on cardiac catheterization. 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