Transcarotid transcatheter aortic valve implantation: A systematic review

Wee, Ian Jun Yan; Stonier, Thomas; Harrison, M.; Choong, Andrew M.T.L.

doi:10.1016/j.jjcc.2018.01.010

Cited by 44 publications

(41 citation statements)

References 43 publications

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“…Patient preference and individual patient factors, such as age and small left ventricular outflow tract, and other factors not normally included in the currently used surgical scoring systems play a significant role. Additionally, compared with TAVR, SAVR continues to have absolute lower rates of residual paravalvular leakage, major vascular complications and new permanent pacemakers 22 (reported as ranging from 13.2 to 17.1%) 46, 47 . Lastly, this randomised evidence arises from the comparison of the most modern TAVR technology with old-fashioned conventional AVR through median sternotomy.…”

Section: Transcatheter Aortic Valve Replacements: Results and Comparimentioning

confidence: 99%

Recent advances in aortic valve replacement

Spadaccio

Alkhamees²,

Al‐Attar

2019

F1000Res

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Aortic valve replacement has stood the test of time but is no longer an operation that is exclusively approached through a median sternotomy using only sutured prostheses. Currently, surgical aortic valve replacement can be performed through a number of minimally invasive approaches employing conventional mechanical or bioprostheses as well as sutureless valves. In either case, the direct surgical access allows inspection of the valve, complete excision of the diseased leaflets, and debridement of the annulus in a controlled and thorough manner under visual control. It can be employed to treat aortic valve pathologies of all natures and aetiologies. When compared with transcatheter valves in patients with a high or intermediate preoperative predictive risk, conventional surgery has not been shown to be inferior to transcatheter valve implants. As our understanding of sutureless valves and their applicability to minimally invasive surgery advances, the invasiveness and trauma of surgery can be reduced and outcomes can improve. This warrants further comparative trials comparing sutureless and transcatheter valves.

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Section: Transcatheter Aortic Valve Replacements: Results and Comparimentioning

confidence: 99%

Recent advances in aortic valve replacement

Spadaccio

Alkhamees²,

Al‐Attar

2019

F1000Res

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“…Transcarotid approach in terms of stroke risk is more controversial. Non-randomized trials found similar neurological outcomes (3.8% 30-day CVE) compared to an historically transfemoral cohort ( 42 ). However, recent evidence with a small number of patients ( n = 22) showed more than twice the number and total volume of new ischemic lesions evaluated by diffusion-weighted magnetic resonance imaging within the left hemisphere ( p < 0.01 for both) when performing TAVI through the left carotid artery ( 43 ).…”

Section: Predictors Of Cerebrovascular Events After Tavimentioning

confidence: 84%

Cerebrovascular Events After Transcatheter Aortic Valve Implantation

Armijo

Nombela‐Franco

Tirado‐Conte

2018

Front. Cardiovasc. Med.

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Transcatheter aortic valve implantation (TAVI) has emerged as an alternative less invasive treatment for patients with symptomatic severe aortic stenosis. Despite the technological development and knowledge improvement in recent years, neurological complications remain a concern, especially with the expansion of the technique toward younger and lower risk patients. Clinical cerebrovascular events have an important impact on patients' morbidity and mortality with a multifactorial origin. While cerebral microembolizations during TAVI is a universal phenomenon and embolic protection devices have been developed in an attempt to reduce them, their clinical utility remains unclear. We review the current evidence on cerebrovascular events associated with TAVI and potential preventive strategies.

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“…However, recent meta-analyses and systematic reviews have suggested that the available data limit formal meta-analysis and, as such, they draw no firm conclusions regarding the safety and efficacy of this method. 31,32…”

Section: Trans-subclavian/transaxillarymentioning

confidence: 99%

Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions

Coughlan

Kiernan

Arnous

2019

Vascular and Endovascular Review

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Transcatheter aortic valve implantation (TAVI) is the usual technique for patients with severe aortic stenosis who are at high risk for surgical aortic valve replacement. The transfemoral (TF) route is the most commonly used access type, and significant progress in this procedure has greatly increased the proportion of patients who can undergo it. Not all patients are suitable for TF TAVI, however, so other routes, including transapical, transaortic, subclavian, trans-subclavian/transaxillary, transcarotid and transcaval, may need to be used. Evidence on these routes shows promising results but the majority of this is registry data rather than randomised controlled trials, so TF TAVI remains the safest access route and should be considered for most patients. However, in patients who are unsuitable for TF TAVI, alternative access routes are safe and feasible. The challenges concern choosing the best route, the valve to use and skill of the specialist centre. This article provides a overview of options for alternative vascular access in TAVI, the clinical rationale for using them, current evidence and areas for clinical investigation.

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Transcarotid transcatheter aortic valve implantation: A systematic review

Abstract: The available data on TC TAVI show comparable technical feasibility with other traditional access routes, representing a viable alternative. However, the paucity of data warrants the need for larger randomized controlled trials to establish a firm conclusion.

Cited by 44 publications

References 43 publications

Recent advances in aortic valve replacement

Recent advances in aortic valve replacement

Cerebrovascular Events After Transcatheter Aortic Valve Implantation

Alternative Access for Transcatheter Aortic Valve Implantation: Current Evidence and Future Directions

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