This expert consensus statement provides a comprehensive review and practical guide on case selection, technical considerations, and outcomes for alternative access routes in TAVR.
This expert consensus statement provides practical guidance on patient selection, imaging, and procedural techniques for alternative access TAVR when transfemoral access is not feasible.
Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR.
Sherwood et al. (Tue,) conducted a review in Symptomatic aortic stenosis. Alternative access routes for TAVR (transaxillary, transcarotid, transcaval) vs. Transfemoral access was evaluated. This expert consensus statement provides a comprehensive review and practical guide on case selection, technical considerations, and outcomes for alternative access routes in TAVR.