Key result
The transaxillary approach is increasingly recognized as a viable alternative non-femoral access route for TAVI procedures due to its proximity and straight course to the aortic annulus.
Why the study?
As TAVI indications expand, standard transfemoral access is unsuitable in up to 10-15% of patients, requiring a better understanding of the second-best access choice.
The transaxillary approach is increasingly recognized as a viable alternative access route for TAVI in the 10-15% of patients unsuitable for transfemoral access.
Non-femoral TAVI access merits evaluation when transfemoral unsuitable; leaves open optimal strategy for low-risk patients.
With transcatheter aortic valve implantation (TAVI) technology expanding its indications for low-risk patients, the number of TAVI-eligible patients will globally grow, requiring a better understanding about the second-best access choice. Regarding the potential access sites, the transfemoral retrograde route is recognized as the standard approach and first choice according to current guidelines. However, this approach is not suitable in up to 10-15% of patients, for whom an alternative non-femoral access is required. Among the alternative non-femoral routes, the transaxillary approach has received increasing recognition due to its proximity and relatively straight course from the axillary artery to the aortic annulus, which provides a more accurate device deployment. Here we discuss some particular aspects of the transaxillary access, either percutaneously performed or by cutdown dissection.
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Tagliari et al. (2020) conducted a review in Transcatheter aortic valve implantation (TAVI). Transaxillary access was evaluated. The transaxillary approach is increasingly recognized as a viable alternative non-femoral access route for TAVI procedures due to its proximity and straight course to the aortic annulus.
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