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Access Options for Transcatheter Aortic Valve Replacement

delete2025-02-28
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OA
AI
J
Jeffrey Chidester
T
Teodora Donisan
P
Parth Desai
S
Sukriti Banthiya
A
Ahmed Zaghloul
M
Michael E. Jessen
K
Ki Park
W
Weiyi Tan
S
Shirling Tsai
L
Lynn C. Huffman
A
Anthony A. Bavry
D
Dharam J. Kumbhani
A
Amit Goyal *
DOI:10.3390/jcm14051651delete
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Abstract

Abstract

En 中文
Transcatheter aortic valve replacement (TAVR) was introduced in 2002 and has become integral in the management of aortic stenosis. As an alternative to surgical aortic valve replacement, it relies heavily on safe access to the aortic annulus for implantation of a valve prosthesis. Throughout its development and in current practice, the transfemoral (TF) arterial route for retrograde valve delivery has been the primary approach. However, this route is not appropriate for all patients, which has led to the development of multiple alternate access options. This review discusses the development of access for TAVR, followed by a thorough discussion of TF access. The commercially available products, preprocedural planning, closure techniques, and procedural complications are all discussed. We also describe the various alternate access routes with particular emphasis on the most recently developed route, transcaval access (TCv), with focus on procedural indications, technical considerations, and comparative outcomes. As TAVR technology, indications, and availability all expand, the knowledge and implementation of safe access are of utmost importance.
Keywords:
arterial access
transcatheter aortic valve replacement
transcaval
transcarotid
transapical
transaortic
transfemoral
transaxillary
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Journal

Journal of Clinical Medicine cover
Journal of Clinical Medicine
IF:
2.9
Papers:
5.0W
Citations:
9.8W

Organization

M
mayo clinic
Scholars:
8.2W
Papers: 6.5W
Citations: 85
U
University of Virginia
Scholars:
3.0W
Papers: 2.7W
Citations: 4.1W
U
US Department of Veterans Affairs
Scholars:
3.8W
Papers: 3.3W
Citations: 47
U
university of texas southwestern medical center dallas
Scholars:
1.8W
Papers: 1.4W
Citations: 28
U
university of texas system
Scholars:
18.5W
Papers: 15.6W
Citations: 210
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