Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral

Abstract AimsEmpirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence. MethodsWe systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017. Searched terms were: (“aortic stenosis” OR “transcatheter aortic” OR “TAVI” OR “TAVR”) and (“transfemoral” OR “transaxillary” OR “transubclavian”). Major outcomes according to Valve Academic Research Consortium‐2 criteria were gathered. The odds ratio (OR) was used as a summary statistic. A random‐effects model was used. A fully percutaneous TSc TAVI case from our institution illustrates minimalist approach. ResultsFinal analysis was made with six studies including 4,504 patients (3,886 TF and 618 TSc). Baseline characteristics of compared groups in individual studies were similar, with the exception of a higher logistic EuroSCORE in the TSc group (23.7 ± 1.92 vs. 21.17 ± 3.51, P = 0.04) and higher prevalence of coronary and peripheral artery disease with OR = 0.67 [95% CI: 0.54–0.83] (P = 0.0003) and OR = 0.08 [95% CI: 0...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: VSD ‐ VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research

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Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
AbstractWith the advent of transcatheter aortic valve replacement (TAVR), appropriately selected intermediate-, high-, and extreme-risk patients with severe aortic stenosis (AS) are now offered a less invasive option compared to conventional surgery. In contemporary practice, TAVR is performed predominantly via a transfemoral arterial approach, whereby a transcatheter heart valve (THV) is delivered in a retrograde fashion through the iliofemoral arterial system and thoraco-abdominal aorta, into the native aortic valve annulus. While the majority of patients possess suitable anatomy for transfemoral arterial access, there i...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve Dis Source Type: research
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Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve Dis Source Type: research
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