Non-transfemoral access sites for transcatheter aortic valve replacement

Journal of Thoracic Disease
Mariah Madigan, Rony Atoui

Abstract

Transfemoral access is currently the standard and preferred access site for transcatheter aortic valve replacement (TAVR), though novel approaches are emerging to expand treatment options for the increasing numbers of patients with a contraindication for the traditional route. Previous publications have provided comparisons between two TAVR access sites, primarily transfemoral versus one of the novel approaches, while others have compared three or four novel approaches. The aim of this report is to provide a comprehensive summary of publications that analyse and compare the six non-transfemoral access sites currently described in the literature. These include the transapical, transaortic, axillary/subclavian, brachiocephalic, transcarotid, and transcaval approaches. Though there remains little consensus as to the superiority or non-inferiority of TAVR approaches, and there has yet to be randomized clinical trials to support published findings, with careful patient and procedural selection, outcomes for novel approaches have been reported to be comparable to standard transfemoral access when performed by skilled physicians. As such, choice of procedure is primarily based on registry data and the judgement of surgical teams as to...Continue Reading

Citations

Aug 3, 2020·Journal of Cardiac Surgery·Jelani K GrantJoao Braghiroli
Jun 20, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Ashraf AbugrounLloyd W Klein
Mar 23, 2021·European Heart Journal. Quality of Care & Clinical Outcomes·Mohammed Y KhanjiAdrian Ionescu
Apr 15, 2021·The Thoracic and Cardiovascular Surgeon·Dritan UseiniJustus Strauch
May 30, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Giorgio A MedrandaRon Waksman
Aug 1, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Dawid L StaudacherTimo Heidt
Aug 21, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Marouane BoukhrisJean-Bernard Masson
May 11, 2020·The Journal of Thoracic and Cardiovascular Surgery·Lucía JunqueraSiamak Mohammadi

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