Suprasternal and Left Axillary Transcatheter Aortic Valve Replacement in Morbidly Obese Patients

Publication date: December 2018Source: The Annals of Thoracic Surgery, Volume 106, Issue 6Author(s): Anna Olds, Kyle Eudailey, Tamim Nazif, Torsten Vahl, Omar Khalique, Clifton Lewis, Rebecca Hahn, Martin Leon, Vinayak Bapat, Mustafa Ahmed, Susheel Kodali, Isaac GeorgeIn morbidly obese patients who cannot undergo transfemoral, transaortic, or transapical transcatheter aortic valve replacement (TAVR) due to body habitus, suprasternal (SS) and left subclavian/axillary artery (LSCLA) approaches may provide safe TAVR access. Nine morbidly obese patients with a body mass index of 35 or more underwent SS-TAVR (7 patients) or LSCLA-TAVR (2 patients) at two institutions from 2015 to 2017. Mean age was 69.4 ± 7.3 years, and mean body mass index was 50.3 ± 10.6. There were no deaths, valve reinterventions, or reoperations. Three patients required new pacemakers. In morbidly obese patients who are not candidates for the other approaches, SS-TAVR and LSCLA-TAVR allow easier vascular access and prevent the need for thoracotomy or sternotomy.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research