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Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review

BACKGROUND: Transcatheter aortic valve implantation (TAVI) via total percutaneous transfemoral approach is an increasingly common technique for aortic stenosis treatment. It is primarily indicated in elderly with serious comorbidities. The epidemiology of these patients tends to overlap with the inc...

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Autores principales: Marciniuk, Piotr, Jagielak, Dariusz, Rogowski, Jan, Gumiela, Piotr, Bury, Kamil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008545/
https://www.ncbi.nlm.nih.gov/pubmed/32039722
http://dx.doi.org/10.1186/s12893-020-0693-3
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author Marciniuk, Piotr
Jagielak, Dariusz
Rogowski, Jan
Gumiela, Piotr
Bury, Kamil
author_facet Marciniuk, Piotr
Jagielak, Dariusz
Rogowski, Jan
Gumiela, Piotr
Bury, Kamil
author_sort Marciniuk, Piotr
collection PubMed
description BACKGROUND: Transcatheter aortic valve implantation (TAVI) via total percutaneous transfemoral approach is an increasingly common technique for aortic stenosis treatment. It is primarily indicated in elderly with serious comorbidities. The epidemiology of these patients tends to overlap with the incidence of femoral hernia (FH). The appearance of hernia sac at the approach site and insufficient preoperational examination can lead to serious complications. We present the first-ever reported case of subsequent femoral hernia repair during transfemoral TAVI. CASE PRESENTATION: This report presents a case of FH/TAVI coincidence and literature review of its epidemiology. Literature review was performed to analyze similarities of femoral hernia and TAVI. The case describes an 84-year old female referred for elective TAVI. Intraoperation incarcerated femoral hernia was noticed and directly repaired. Further TAVI steps were performed on regular basis. A 2-year follow-up reported no local and general complications related to procedures. CONCLUSIONS: Unsuspected femoral hernia found subsequently with transfemoral TAVI may become a growing problem. The number of TAVI performed rises with indications expansion. Femoral hernia repairs constitute from 2 to 4% of all groin hernia. Both TAVI and FH are connected with elderly. Despite the fact of low FH incidence, growing number of TAVI performed and ageing of population, corresponds with higher possibility of complications. Most of these complications may end up fatal as they would involve high-risk patients. Insufficient attention is paid by cardiologists to the possible hernia appearance in the access site as this issue has been hardly ever presented in literature. Concomitant FH in TAVI patients should always be excluded in order to avoid serious complications. The case we report presents a successful subsequent FH repair during TAVI procedure. Further studies have to be conducted to provide data on how such problems ought to be managed.
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spelling pubmed-70085452020-02-13 Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review Marciniuk, Piotr Jagielak, Dariusz Rogowski, Jan Gumiela, Piotr Bury, Kamil BMC Surg Case Report BACKGROUND: Transcatheter aortic valve implantation (TAVI) via total percutaneous transfemoral approach is an increasingly common technique for aortic stenosis treatment. It is primarily indicated in elderly with serious comorbidities. The epidemiology of these patients tends to overlap with the incidence of femoral hernia (FH). The appearance of hernia sac at the approach site and insufficient preoperational examination can lead to serious complications. We present the first-ever reported case of subsequent femoral hernia repair during transfemoral TAVI. CASE PRESENTATION: This report presents a case of FH/TAVI coincidence and literature review of its epidemiology. Literature review was performed to analyze similarities of femoral hernia and TAVI. The case describes an 84-year old female referred for elective TAVI. Intraoperation incarcerated femoral hernia was noticed and directly repaired. Further TAVI steps were performed on regular basis. A 2-year follow-up reported no local and general complications related to procedures. CONCLUSIONS: Unsuspected femoral hernia found subsequently with transfemoral TAVI may become a growing problem. The number of TAVI performed rises with indications expansion. Femoral hernia repairs constitute from 2 to 4% of all groin hernia. Both TAVI and FH are connected with elderly. Despite the fact of low FH incidence, growing number of TAVI performed and ageing of population, corresponds with higher possibility of complications. Most of these complications may end up fatal as they would involve high-risk patients. Insufficient attention is paid by cardiologists to the possible hernia appearance in the access site as this issue has been hardly ever presented in literature. Concomitant FH in TAVI patients should always be excluded in order to avoid serious complications. The case we report presents a successful subsequent FH repair during TAVI procedure. Further studies have to be conducted to provide data on how such problems ought to be managed. BioMed Central 2020-02-10 /pmc/articles/PMC7008545/ /pubmed/32039722 http://dx.doi.org/10.1186/s12893-020-0693-3 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Marciniuk, Piotr
Jagielak, Dariusz
Rogowski, Jan
Gumiela, Piotr
Bury, Kamil
Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title_full Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title_fullStr Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title_full_unstemmed Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title_short Femoral hernia in the era of TAVI – a potential obstacle for transfemoral approach: a case report and literature review
title_sort femoral hernia in the era of tavi – a potential obstacle for transfemoral approach: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008545/
https://www.ncbi.nlm.nih.gov/pubmed/32039722
http://dx.doi.org/10.1186/s12893-020-0693-3
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