Transcatheter Aortic Valve Replacement: Alternative Access beyond the Femoral Arterial Approach

Raptis, Demetrios A.; Beal, Michael A; Kraft, David C.; Maniar, Hersh S.; Bierhals, Andrew J.

doi:10.1148/rg.2019180059

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…The CoreValve Revalving System is available in sizes ranging from 23 mm to 34 mm. 13 Transcatheter aortic valve implantation (TAVI) for the treatment of symptomatic and severe aortic valve stenosis (AS) has rapidly evolved during the last decade. TAVI has proven superior or non-inferior against surgical aortic valve replacement (SAVR) for patients at high, intermediate or low surgical risk.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Alternative Peripheral and Transcatheter Aortic Valve Replacement : Systematic Review

Sabri,

Nasution,

Namora Siregar

et al. 2023

JARMHS

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Background: Transcatheter aortic valve replacement (TAVR) is approved for use in low-to-extreme-risk patients with aortic stenosis, with volumes exceeding those of surgical aortic valve replacement and outcomes continuing to improve. The transfemoral (TF) access route is accepted as the first choice for TAVR and accounts for 95 of cases. However, the use of alternative access remains relevant in many patients with peripheral vascular disease or unfavorable anatomy. The aim: This study aims to show about comparison of alternative peripheral and transcatheter aortic valve replacement. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 135 articles, whereas the results of our search on SagePub brought up 118 articles. The results of the search conducted for the last year of 2013 yielded a total 56 articles for PubMed and 33 articles for SagePub. The result from title screening, a total 16 articles for PubMed and 10 articles for SagePub. In the end, we compiled a total of 8 papers. We included five research that met the criteria. Conclusion: To compare outcomes among transcatheter aortic valve replacement (TAVR) performed via transaortic (TAo) and subclavian (SCL) approaches. Many patients are not amenable for TAVR via the transfemoral route due to peripheral vascular disease. Limited data exist regarding safety and procedural feasibility of TAVR via TAo and SCL routes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Alternative Peripheral and Transcatheter Aortic Valve Replacement : Systematic Review

Sabri,

Nasution,

Namora Siregar

et al. 2023

JARMHS

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show abstract

“…Also, peripheral artery disease, which is a major comorbidity in patients referred for TAVR, provides challenge in completing the TF-TAVR procedure in patients with comorbidities associated with femoral access routes such as iliofemoral arteries with severe narrowing, or an artificial bypass graft [4]. In these situations, other access routes like subclavian access are more typically utilized [5]. Our patient had stenosed subclavian artery; thus, we elected to use the TF route despite his history of aortobifemoral bypass graft.…”

Section: Discussionmentioning

confidence: 99%

Achieving Hemostasis Posttranscatheter Aortic Valve Replacement in a Patient with Aortobifemoral Bypass Graft Using Perclose Device: A Novel Technique

Ezeh

Amro²,

Akhigbe

et al. 2021

Case Reports in Cardiology

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The presence of aortobifemoral bypass graft can complicate vascular access during percutaneous intervention. Choosing an access route for transcatheter aortic valve replacement (TAVR) in this patient population can be challenging. Access options are further limited by the presence of coexisting vascular comorbidities such as extensive peripheral artery diseases in these patients. Adequate preoperative planning to determine the suitability of different access sites is, therefore, very crucial. Our case report shows that the use of Perclose can be a viable option for achieving hemostasis after a direct puncture of an aortobifemoral bypass graft during transfemoral TAVR.

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“…SCA-TAVR is regarded as a favorable and less invasive alternative approach since it involves a short distance between the puncture site and the aortic annulus and is generally free of atherosclerotic calcification and significant tortuosity [10]. In the CoreValve trial, outcomes at 30 days and 1 year after treatment with SCA-TAVR were comparable to those in the TF group [11].…”

Section: Trans-subclavian/axillary Arterial Accessmentioning

confidence: 99%

“…Similar to TF-TAVR, SCA-TAVR is restricted by vascular stenosis (<6 mm), substantial calcification and extensive tortuosity. In addition, a valve angle of >70 is considered a relative contraindication to SCA-TAVR [10,11].…”

Section: Trans-subclavian/axillary Arterial Accessmentioning

confidence: 99%

“…The multicenter prospective ROUTE study demonstrated the efficacy and safety of transaortic access implantation of SAPIEN XT and SAPIEN 3 transcatheter heart valves in elderly patients with multiple comorbidities [12]. However, transaortic access requires general anesthesia and surgical manipulation of the chest wall, thus limiting older patients with pre-existing pulmonary disease (such as pleural plaques or pleural disease) and pre-existing vascular conditions (such as aortic dissection or aneurysm at a prior aortotomy site) [10].…”

Section: Transaortic Accessmentioning

confidence: 99%

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Transcatheter Aortic Valve Replacement in Elderly Patients: Opportunities and Challenges

Huang,

Yan,

et al. 2023

JCDD

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Over the past two decades, the rapid evolution of transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe aortic stenosis (AS) in the elderly. The prevalence of comorbidities in elderly AS patients presents a considerable challenge to the effectiveness and prognosis of patients after TAVR. In this article, we aim to summarize some of the clinical aspects of the current use of TAVR in elderly patients and attempt to highlight the challenges and issues that need further consideration.

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Transcatheter Aortic Valve Replacement: Alternative Access beyond the Femoral Arterial Approach

Cited by 8 publications

References 25 publications

Comparison of Alternative Peripheral and Transcatheter Aortic Valve Replacement : Systematic Review

Comparison of Alternative Peripheral and Transcatheter Aortic Valve Replacement : Systematic Review

Achieving Hemostasis Posttranscatheter Aortic Valve Replacement in a Patient with Aortobifemoral Bypass Graft Using Perclose Device: A Novel Technique

Transcatheter Aortic Valve Replacement in Elderly Patients: Opportunities and Challenges

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