Alternative arterial access sites such as the subclavian, ascending aorta, and carotid arteries provide viable options for TAVI in patients with severe iliofemoral arteriopathy who cannot undergo the transfemoral approach.
Answers are grounded in this paper and cite their sources.
Alternative access sites warrant consideration in select TAVI patients; leaves open need for comparative outcome data.
Transcatheter aortic valve implantation (TAVI) is used to treat elderly patients with severe aortic stenosis who are considered extremely high-risk surgical candidates. The safety and effectiveness of TAVI have been demonstrated in numerous studies. The self-expanding CoreValve bioprosthesis (Medtronic Inc., Minneapolis, MN, USA) was the first transcatheter aortic valve to be granted the Conformité Européene (CE) mark in May 2007 for retrograde transfemoral implantation. However, TAVI patients are also often affected by severe iliofemoral arteriopathy. In these patients, the retrograde transfemoral approach carries a high risk of vascular injury, making this approach unusable. Alternative arterial access sites, such as the subclavian artery, the ascending aorta, and the carotid artery, have been used for retrograde implantation of the CoreValve bioprosthesis. In the present report, we present the procedural considerations, risks, and benefits of the different types of arterial access used to implant the CoreValve bioprosthesis.
No takes yet. Share an insight, caveat, or question.
Bruschi et al. (2015) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: