{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:31:23Z","timestamp":1793946683225,"version":"4.8.0"},"reference-count":0,"publisher":"Kare Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anatol J Cardiol"],"abstract":"<jats:p>Background: Transfemoral access is the default approach for transcatheter aortic valve implantation (TAVI) and left atrial appendage closure (LAAC). Although ultrasound (US)-guided femoral puncture improves first-pass success and reduces vascular complications in randomized trials, real-world data in contemporary structural heart interventions, including both arterial and venous large-sheath access, remain limited. The authors aimed to compare US-guided vs. conventional transfemoral access in patients undergoing TAVI and LAAC.\r\n\r\nMethods: This single-center, retrospective cohort study included 165 consecutive patients undergoing transfemoral structural procedures between January 2022 and December 2024 (93: TAVI; 72: LAAC). Ultrasound guidance was used in 57 procedures (34.5%). Arterial and venous cohorts were analyzed separately. Primary outcomes were absolute hemoglobin decrease (\u0394Hb) and access-site vascular complications (hematoma, pseudoaneurysm, and arteriovenous fistula). In the arterial cohort, 1 : 1 propensity score matching was performed to adjust for baseline differences.\r\n\r\nResults: Hemoglobin decline was significantly smaller with US guidance in both venous \r\n(0.80 \u00b1 0.95 vs. 1.50 \u00b1 1.11 g\/dL; P = .009) and arterial procedures (0.58 \u00b1 0.97 vs. 1.29 \u00b1 1.00 g\/dL; P = .002). In the venous cohort, complication rates were numerically lower but not statistically different (3.8% vs. 17.4%; P = .143). In contrast, arterial complications were significantly reduced with US guidance. After propensity matching (31 patients per group), \r\ncomplications occurred in 3.2% vs. 29.0% [Absolute Risk Reduction(ARR) = 25.8%, Number Need to Treat (NNT) = 4, P = .013].\r\n\r\nConclusions: Ultrasound-guided transfemoral access was associated with reduced hemoglobin decline and fewer vascular complications, particularly in large-bore arterial procedures, supporting routine integration of real-time US guidance in structural interventions.<\/jats:p>","DOI":"10.14744\/anatoljcardiol.2026.6536","type":"journal-article","created":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:11:11Z","timestamp":1793945471000},"source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-Guided versus Fluoroscopy-Guided Femoral Access for Structural Heart Procedures: Outcomes From Transcatheter Aortic Valve Implantation and Left Atrial Appendage Closure"],"prefix":"10.14744","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5232-8436","authenticated-orcid":false,"given":"Ahmet","family":"K\u0131vrak","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-801X","authenticated-orcid":false,"given":"Can","family":"Sezer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-1706","authenticated-orcid":false,"given":"U\u011fur","family":"Canpolat","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-7268","authenticated-orcid":false,"given":"Ahmet\u00a0Hakan","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6544-2122","authenticated-orcid":false,"given":"Selahattin","family":"\u00c7\u00f6p","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5520-7103","authenticated-orcid":false,"given":"Cem","family":"\u00c7\u00f6teli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7673-229X","authenticated-orcid":false,"given":"Hikmet","family":"Yorgun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0985-3144","authenticated-orcid":false,"given":"Mehmet\u00a0Levent","family":"\u015eahiner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-3704","authenticated-orcid":false,"given":"Erg\u00fcn\u00a0Bar\u0131\u015f","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7914-0169","authenticated-orcid":false,"given":"Necla","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-8424","authenticated-orcid":false,"given":"Kudret","family":"Aytemir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5966","published-online":{"date-parts":[[2026]]},"container-title":["The Anatolian Journal of Cardiology"],"original-title":[],"link":[{"URL":"https:\/\/file.paplino.com\/anatoljcardiol\/pdfs\/1792420889-en.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:11:12Z","timestamp":1793945472000},"score":1,"resource":{"primary":{"URL":"https:\/\/anatoljcardiol.com\/article\/AJC-98637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"URL":"https:\/\/doi.org\/10.14744\/anatoljcardiol.2026.6536","relation":{},"ISSN":["2149-2271","2149-2263"],"issn-type":[{"value":"2149-2271","type":"print"},{"value":"2149-2263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}