Transcatheter aortic valve implantation using the left transcarotid approach in patients with previous ipsilateral carotid endarterectomy

Pozzi, Mattéo; Grinberg, Daniel; Obadia, Jean‐François; Saroul, C.; Green, Lisa; Dementhon, Julie; Pizzighini, S.; Rioufol, Gilles; Finet, Gérard; Modine, Thomas

doi:10.1002/ccd.25779

Cited by 17 publications

(20 citation statements)

References 19 publications

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“…More recently, Azmoun et al reported no cerebrovascular events or access site complications in a series of 19 patients undergoing TAVI of both self-expanding and balloon-expandable valves via transcarotid access under local anaesthesia [15]. To date, further available data seem to confirm the safety and feasibility of this access site [16,17]. Furthermore, a first report of valve-in-valve implantation for degenerated stentless aortic root conduits with severe regurgitation via transcarotid access has described three uneventful cases [18].…”

Section: Discussionmentioning

confidence: 91%

Transcutaneous aortic valve implantation using the carotid artery access: Feasibility and clinical outcomes

Kallinikou

Berger

Ruchat

et al. 2017

Archives of Cardiovascular Diseases

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Section: Discussionmentioning

confidence: 91%

Transcutaneous aortic valve implantation using the carotid artery access: Feasibility and clinical outcomes

Kallinikou

Berger

Ruchat

et al. 2017

Archives of Cardiovascular Diseases

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“…20 of those reported) were found to have mild paravalvular regurgitation (13,15,19,22,23), while three patients (4.1% of those reported) were found to have moderate paravalvular regurgitation (8,15,24); there was no incidence of severe paravalvular regurgitation.…”

Section: Accepted M Manuscriptmentioning

confidence: 85%

“…Two transient ischaemic attacks were reported (10,18). 10 patients required a transfusion of at least 2 units of packed red cells (8,15,19). One patient required new dialysis for acute kidney injury (19).…”

Section: Other Perioperative Outcomesmentioning

confidence: 99%

“…One patient had a dissection intraoperatively which resolved (10). The most common complication was the need for insertion of a permanent pacemaker, which was required in nine cases (12.2%) (8,15,18,(20)(21)(22). The reasons for each pacemaker insertion are detailed along with the individual outcome data for each study in Table 4.…”

Section: Other Perioperative Outcomesmentioning

confidence: 99%

“…The transaortic approach offers similar drawbacks through the need for a general anaesthetic and an upper ministernotomy (8). It can be challenging from a surgical perspective in patients who have undergone a previous coronary artery bypass graft (CABG) with patent venous grafts.…”

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confidence: 99%

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A systematic review of transcatheter aortic valve implantation via carotid artery access

Stonier

Harrison

Choong

2016

International Journal of Cardiology

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& Keywords BackgroundThe carotid artery is a novel access route for transcatheter aortic valve implantation (TAVI). This may represent a viable alternative in patients unsuitable for TAVI via traditional transfemoral access, up to 20%, as well as other access routes such as subclavian, transapical and aortic. This systematic review summarises the current evidence for its safety and feasibility. Methods A systematic review was conducted as per the Preferred Reporting Instructions forSystematic Reviews and Meta-analysis (PRISMA) guidelines using five electronic databases. Results16 studies were identified, including three prospective cohort studies, one retrospective cohort study, three case series and eight case reports. Data on 74 patients (mean age 76.9 years) was extracted including pre-operative work-up, technical procedure details and outcomes.This found 1 intraoperative death, 2 further deaths within 30 days, two incidences of transient ischaemic attack, no incidences of stroke, myocardial infarction, carotid A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 access site complications or infection, 1 patient required new dialysis and 1 patient had an intraoperative dissection which resolved. Follow-up from 30 days to 1 year showed symptomatic improvement and echocardiographic improvement in line with those seen in transfemoral TAVI. ConclusionsThe available data on TAVI via carotid access demonstrate technical feasibility with comparable outcomes to other traditional access routes. A low number of patients, heterogeneous clinical endpoints and relatively short follow-up periods limit formal meta-analysis and firmer conclusions. For patients in which other access routes are impossible, TAVI via carotid access represents a viable and potentially crucial alternative in patients who might otherwise be untreatable.

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Carotid access for transcatheter aortic valve replacement: A meta‐analysis

Sharma

Chaudhary

Ghuneim

et al. 2020

Cathet Cardio Intervent

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Objective We sought to evaluate the feasibility and safety of carotid access transcatheter aortic valve replacement (TAVR) by performing a meta‐analysis of published cases. Background Several case series and regional data have provided initial basis for carotid access TAVR in patients with prohibitive femoral approach. We performed this meta‐analysis to provide further evidence of feasibility and safety of carotid TAVR. Methods We searched PubMed, EMBASE, CINAHL, and Cochrane CENTRAL for any study on carotid access TAVR involving ⩾5 patients since inception till March 1, 2020. Random‐effects model was used to compute overall effects. The outcomes analyzed were all‐cause mortality, Transient ischemic attack (TIA)/stroke, need for permanent pacemaker (PPM) implantation, pericardial tamponade, access site complications, major bleeding, and length of stay. Results There was a total of 17 retrospective studies (n = 2082) with a median follow‐up of 1 month. Mean age of the patient was 80 years. Mean Euroscore and STS scores were 15 ± 6.2 and 7.9 ± 3.3, respectively. The procedural success rate was 99%. The rate of all‐cause mortality was 6.7% (range 4.6–9.7%, p < .001, I2 = 67%). Incidence of TIA/stroke was 3.9% (range 3.1–4.8%, p < .001, I2 = 0%) and PPM implantation was 16.7% (range 12.5–21.9%, p < .001, I2 = 56%). Rate of pericardial tamponade, vascular complication, and major bleeding were 1.7, 2.5, and 7%, respectively. Average length of hospital stay was 7.7 days. Conclusion Our results show that transcarotid approach is a feasible option in patients with prohibitive femoral access for TAVR.

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Transcatheter aortic valve implantation using the left transcarotid approach in patients with previous ipsilateral carotid endarterectomy

Cited by 17 publications

References 19 publications

Transcutaneous aortic valve implantation using the carotid artery access: Feasibility and clinical outcomes

Transcutaneous aortic valve implantation using the carotid artery access: Feasibility and clinical outcomes

A systematic review of transcatheter aortic valve implantation via carotid artery access

Carotid access for transcatheter aortic valve replacement: A meta‐analysis

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