scholarly journals The Transaxillary Approach via Prosthetic Conduit for Transcatheter Aortic Valve Replacement With the New-Generation Balloon-Expandable Valves in Patients With Severe Peripheral Artery Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Alexander Lind ◽  
Alina Zubarevich ◽  
Arjang Ruhparwar ◽  
Matthias Totzeck ◽  
Rolf Alexander Jánosi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Peripheral Artery ◽  
Access Site ◽  
Transcatheter Aortic Valve ◽  
Artery Disease ◽  
New Generation ◽  
Access Technique

Background: The left subclavian artery (LSA) is an infrequently used alternative access route for patients with severe peripheral artery disease (PAD) in patients who underwent transcatheter aortic valve replacement (TAVR). We report a new endovascular approach for TAVR combining an axillary prosthetic conduit-based access technique with new-generation balloon-expandable TAVR prostheses.Methods and Results: Between January 2020 and December 2020, 251 patients underwent TAVR at the West German Heart and Vascular Center. Of these, 10 patients (3.9%) were deemed to be treated optimally by direct surgical exposure of the left or right axillary artery via a surgically adapted prosthetic conduit. All procedures were performed under general anesthesia. One procedural stroke occurred due to severe calcification of the aortic arch. No specific complications of the subclavian access site (vessel rupture, vertebral, or internal mammary ischemia) were reported. Two minor bleedings from the access site could be treated conservatively. No surgical revision was necessary.Conclusion: The axillary prosthetic conduit-based access technique using new-generation balloon-expandable valves allows safe and successful TAVR in a subgroup of patients with a high risk of procedural complications due to severe peripheral vascular disease. Considering the increasing number of patients referred for TAVR, this approach could represent an alternative for patients with limited access sites.

scholarly journals Comparison between Surgical Access and Percutaneous Closure Device in 787 Patients Undergoing Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 10 (7) ◽  
pp. 1344
Author(s):  
Dennis Eckner ◽  
Francesco Pollari ◽  
Giuseppe Santarpino ◽  
Jürgen Jessl ◽  
Johannes Schwab ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Academic Research ◽  
Peripheral Artery ◽  
Transcatheter Aortic Valve ◽  
Surgical Access ◽  
Artery Disease ◽  
Research Consortium

Background: The vascular access in transcatheter aortic valve replacement (TAVR) was initially dominated by a surgical approach. Meanwhile, percutaneous closure systems became a well-established alternative. The aim of this study was to compare the clinical outcome between the two approaches. Methods: In this retrospective study, we observed 787 patients undergoing a TAVR-Procedure between 2013 and 2019. Of those, 338 patients were treated with surgical access and 449 with the Perclose ProGlide™-System (Abbott, Chicago, IL, USA). According to the Bleeding Academic Research Consortium (BARC) and Valve Academic Research Consortium (VARC) criteria, the primary combined endpoints were defined. Results: Overall hospital mortality was 2.8% with no significant difference between surgical (3.8%) and percutaneous (2.2%) access (p = 0.182). Major vascular complications or bleeding defined as the primary combined endpoint was not significantly different in either group (Surgical group 5.3%, ProGlide group 5.1%, p = 0.899). In the ProGlide group, women with pre-existing peripheral artery disease (PAD) were significantly more often affected by a vascular complication (p = 0.001 for female sex and p = 0.03 for PAD). Conclusions: We were able to show that the use of both accesses is safe. However, the surgical access route should also be considered in case of peripheral artery disease.

CAROTID ARTERY AS AN ALTERNATE ACCESS SITE FOR TRANSCATHETER AORTIC VALVE REPLACEMENT

2020 ◽  
Vol 75 (11) ◽  
pp. 1475
Author(s):  
Sharan Sharma ◽  
Arjun Raval ◽  
Angela Ghuneim ◽  
Kelsey Patel ◽  
William Harder ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Carotid Artery ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Access Site ◽  
Transcatheter Aortic Valve

scholarly journals Use of extracorporeal membrane oxygenation as a bridge to transcatheter aortic valve replacement in a patient with aortic stenosis and severe coronary artery disease: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Majid Ahsan ◽  
Rolf Alexander Jánosi ◽  
Tienush Rassaf ◽  
Alexander Lind
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease

Abstract Background Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. Case summary Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. Discussion Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.

scholarly journals Interaction Between Frailty and Access Site in Older Adults Undergoing Transcatheter Aortic Valve Replacement

2018 ◽  
Vol 11 (21) ◽  
pp. 2185-2192 ◽  
Author(s):  
Laura M. Drudi ◽  
Matthew Ades ◽  
Anita Asgar ◽  
Louis Perrault ◽  
Sandra Lauck ◽  
...  
Keyword(s):  
Older Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Access Site ◽  
Transcatheter Aortic Valve
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