Methods: Between June 2013 and September 2015, a total of 111 consecutive patients (56 males, 55 females; mean age 77.7±7.4 years; range, 52 to 95 years) who underwent transcatheter aortic valve implantation via transfemoral artery access were included in the study. Femoral artery access site was closed by a percutaneous closure device in 67 patients (60.4%) and by conventional surgery in 44 patients (39.6%). Safety and efficiency of both techniques were assessed in terms of the complications, re-interventions, and re-hospitalizations during the postoperative 30 days.

Results: Four patients (6%) experienced technical complications with the percutaneous closure device. A total of 53 (79.1%) patients in the percutaneous closure device group and 42 (95.5%) patients in the conventional surgery group achieved technical success without any need for re-intervention. A significantly higher number of percutaneous closure device patients experienced total vascular complications [22 (32.9%) vs 5 (11.4%); p=0.012] and needed secondary vascular interventions [12 (17.9%) vs 2 (4.6%); p=0.043], [emergency surgical intervention 2 (3%), percutaneous balloon angioplasty 12 (17.9%), and graft-stent implantation 7 (10.4%)], compared to the conventional surgery group. However, the rate of postprocedural wound complications, including lymphorrhea and infection, was higher [15 (34%) vs 6 (9%)] and the length of hospital stay was longer in conventional surgery group (4.7±1.2 vs 4.2±1.6 days; p=0.04).

Conclusion: Our study findings suggest that conventional surgery is more effective and safer than the percutaneous closure device for femoral artery access site closure during transcatheter aortic valve implantation procedures with a lower rate of periprocedural complications and re-interventions. In contrast, femoral artery access site closure by a percutaneous closure device seems to be associated with less postprocedural wound site complications than conventional surgery.