Subject(s)
Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Humans , Heart Valve Prosthesis Implantation/instrumentation , Heart Valve Prosthesis Implantation/adverse effects , Heart Valve Prosthesis Implantation/methods , Heart Valve Prosthesis/adverse effects , Mitral Valve/surgery , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Mitral Valve Insufficiency/surgery , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/physiopathology , Treatment Outcome , Prosthesis Failure , Female , Male , Cardiac Catheterization/instrumentation , Cardiac Catheterization/methods , Cardiac Catheterization/adverse effects , Aged , Echocardiography, TransesophagealSubject(s)
Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Mitral Valve Insufficiency , Humans , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Pannus , Treatment Outcome , Heart Valve Prosthesis Implantation/adverse effects , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/surgery , Cardiac Catheterization/adverse effectsSubject(s)
Heart Valve Diseases , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Mitral Valve Insufficiency , Humans , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Treatment Outcome , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/adverse effects , Cardiac Catheterization/adverse effects , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/surgerySubject(s)
Aortic Valve Stenosis , Bioprosthesis , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Heart Valve Prosthesis Implantation/adverse effects , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Prosthesis Design , Prosthesis FailureSubject(s)
Aortic Valve Stenosis , Heart Valve Prosthesis , Transcatheter Aortic Valve Replacement , Humans , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Treatment Outcome , Transcatheter Aortic Valve Replacement/adverse effects , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Prosthesis DesignABSTRACT
BACKGROUND: Trans-radial access has rapidly become the standard for percutaneous coronary procedures in the last decade. As proceduralists overcome the learning curve and become more competent in trans-radial access, alternative safe access sites such as the ulnar artery have been increasingly used for emergent and elective procedures. The aim of this study was to synthesize the best available evidence of the impact on major adverse cardiac events (MACE) of ulnar artery compared to radial artery cardiac catheterization. METHODS: This review considered randomized controlled trials that included adult patients who had a percutaneous coronary procedure via the radial or ulnar artery. The intervention of interest was the use of ulnar compared to radial artery for cardiac catheterization. An extensive search was undertaken for published and unpublished trials up to May 2017. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) checklist. Data were analyzed using Review Manager. RESULTS: A total of six trials were included in the review. There was no statistically significant difference in the incidence of MACE between patients who underwent trans-ulnar or trans-radial artery catheterization (OR 0.90; 95% CI 0.65-1.25). Complications associated with access including hematoma formation, (n = 6 trials) pseudo-aneurysm, and arterio-venous fistulae formation (n = 5 trials), were investigated in a total of 5,276 patients, with no difference in these complications noted between the two groups. There were no differences in arterial access time, fluoroscopy time, and contrast load between the two groups. CONCLUSIONS: There is evidence to support safe use of the ulnar artery as an alternative to the radial artery for access for cardiac catheterization.