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May 1, 2017Journal of Thoracic DiseaseOpen Access

Vascular approaches for transcatheter aortic valve implantation

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Key result

Transfemoral access is the preferred delivery route for transcatheter aortic valve implantation, while alternative approaches such as transapical, transaxillary, and transaortic are available for unsuitable candidates.

Population

Patients with severe aortic stenosis who are unsuitable for surgery because of technical/anatomical issues…

Design

Review

Authors

IPIsaac PascualInterventional CardiologyACAmelia CarroInstituto de Investigación Sanitaria del Principado de AsturiasPAPablo AvanzaCentral University Hospital of Asturias

Discussion

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Implication

*Clinical meaning:* Reinforces current practice of prioritizing transfemoral access while tailoring.

Structured PICO

P
Population
Patients with severe aortic stenosis (AS) who are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk
I
Intervention
Transcatheter aortic valve implantation (TAVI) via various vascular approaches (transfemoral, transapical, transaxillary/subclavian, transaortic, transcarotid, transcaval)

While the transfemoral approach is the standard for TAVI, alternative vascular access routes provide viable options for patients with unfavorable iliofemoral anatomy.

Cite This Study

Pascual et al. (2017) conducted a review in Severe aortic stenosis. Vascular approaches for transcatheter aortic valve implantation (TAVI) was evaluated. Transfemoral access is the preferred delivery route for transcatheter aortic valve implantation, while alternative approaches such as transapical, transaxillary, and transaortic are available for unsuitable candidates.

synapsesocial.com/papers/6a7da595f980e836411872f9https://doi.org/10.21037/jtd.2017.05.73
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis2002 · 3,198 citations
  2. 2Transaxillary Approach Short- and Mid-Term Results in a Single-Center Experience2011 · 16 citations
  3. 3Carotid artery access for transcatheter aortic valve replacement2012 · 47 citations
  4. 4Transcatheter Aortic-Valve Replacement with a Self-Expanding Prosthesis2014 · 2,921 citations
  5. 5One-Year Outcomes of Cohort 1 in the Edwards SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry2011 · 530 citations