Key result
Transcatheter aortic valve implantation of a 26-mm CoreValve prosthesis via the right subclavian artery was successfully performed in a 66-year-old woman with severe peripheral vascular disease.
Case Report (n=1)
No
This case report demonstrates the feasibility of using the right subclavian artery as an alternative access route for TAVR in patients with severe peripheral vascular disease contraindicating transfemoral access.
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Subclavian access may enable TAVR when femoral routes are unsuitable; leaves open comparative safety and durability data.
We successfully implanted a bioprosthetic aortic valve via the right subclavian artery within the framework of the CoreValve transapical aortic valve replacement (TAVR) ReValving (CoreValve, Irvine, CA, USA) clinical trial on November 20, 2007, at the Clinic for Cardiovascular Surgery at the German Heart Center Munich, Technical University Munich. The self-expanding aortic valve prosthesis is primarily designed for retrograde delivery across the aortic valve. The described approach via the right subclavian artery was performed because of severe peripheral vascular disease of the femoral and iliac arteries, as well as the left subclavian artery, and because a transapical delivery system was not available at the time of surgery.
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Ruge et al. (2008) conducted a case report in Severe aortic stenosis with severe peripheral vascular disease (n=1). CoreValve ReValving System via right subclavian artery access was evaluated on Successful implantation and valve function. Transcatheter aortic valve implantation of a 26-mm CoreValve prosthesis via the right subclavian artery was successfully performed in a 66-year-old woman with severe peripheral vascular disease.
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