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The Role of the Axillary Artery as a Second Access Choice in TAVI Procedures


Tagliari, Ana Paula; Saadi, Rodrigo Petersen; Ferrari, Enrico; Taramasso, Maurizio; Saadi, Eduardo Keller (2020). The Role of the Axillary Artery as a Second Access Choice in TAVI Procedures. Revista Brasileira de Cirurgia Cardiovascular:Epub ahead of print.

Abstract

With transcatheter aortic valve implantation (TAVI) technology expanding its indications for low-risk patients, the number of TAVIeligible patients will globally grow, requiring a better understanding about the second-best access choice. Regarding the potential access sites, the transfemoral retrograde route is recognized as the standard approach and first choice according to current guidelines. However, this approach is not suitable in up to 10-15% of patients, for whom an alternative non-femoral access is required. Among the alternative non-femoral routes, the transaxillary approach has received increasing recognition due to its proximity and relatively straight course from the axillary artery to the aortic annulus, which provides a more accurate device deployment. Here we discuss some particular aspects of the transaxillary access, either percutaneously performed or by cutdown dissection.

Abstract

With transcatheter aortic valve implantation (TAVI) technology expanding its indications for low-risk patients, the number of TAVIeligible patients will globally grow, requiring a better understanding about the second-best access choice. Regarding the potential access sites, the transfemoral retrograde route is recognized as the standard approach and first choice according to current guidelines. However, this approach is not suitable in up to 10-15% of patients, for whom an alternative non-femoral access is required. Among the alternative non-femoral routes, the transaxillary approach has received increasing recognition due to its proximity and relatively straight course from the axillary artery to the aortic annulus, which provides a more accurate device deployment. Here we discuss some particular aspects of the transaxillary access, either percutaneously performed or by cutdown dissection.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiac Surgery
04 Faculty of Medicine > Cardiocentro Ticino
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:23 December 2020
Deposited On:14 Jan 2021 13:00
Last Modified:10 Feb 2021 15:12
Publisher:Sociedade Brasileira de Cirurgia Cardiovascular
ISSN:0102-7638
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.21470/1678-9741-2020-0343
PubMed ID:33355810

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