Transcarotid transcatheter aortic valve replacement (TAVR) is increasingly accepted as a safe and efficacious alternative when transfemoral access is contraindicated. Technical and anatomic considerations unique to transcarotid access warrant several adaptations to the routine TAVR procedure. This report describes an approach to overcome these challenges and improve efficiency, including adoption of the "flip-n-flex" technique originally developed for right transaxillary TAVR. This technique has been used at Tufts Medical Center (Boston, MA) since 2019 in both left and right transcarotid TAVR approaches with success to ensure coaxial alignment of the transcatheter heart valve to the aortic root.
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http://dx.doi.org/10.1016/j.athoracsur.2022.03.014 | DOI Listing |
Eur Heart J Case Rep
November 2024
Department of Thoracic and Cardiovascular Surgery, Saga University, 5 -1-1 Nabeshima, Saga Shi, Saga Ken 849-8501, Japan.
Int J Cardiol
January 2025
Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America.
Background: Anatomical factors may preclude transfemoral (TF) arterial access for transcatheter aortic valve implantation (TAVI). Transcaval (TCav) access has been utilized as an alternative access for these patients. We aimed to investigate the outcomes of TCav access in patients undergoing TAVI.
View Article and Find Full Text PDFFuture Cardiol
October 2024
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Transcatheter aortic valve replacement (TAVR) has become the standard of care for high surgical risk patients with aortic stenosis. The most common approach to TAVR is transfemoral utilizing monitored anesthesia care or general anesthesia. On occasion, transfemoral access is not possible and alternative access to TAVR is required.
View Article and Find Full Text PDFJ Clin Med
August 2024
Department of Cardiac Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK.
Transcatheter aortic valve implantation (TAVI) has revolutionised the management of severe aortic stenosis, particularly for patients deemed high risk or inoperable for traditional surgical aortic valve replacement. The transfemoral approach is the preferred route whenever feasible, attributed to its minimally invasive nature, reduced procedural morbidity, and shorter recovery times. In total, 80-90% of TAVI procedures are performed via the transfemoral route.
View Article and Find Full Text PDFJ Cardiovasc Transl Res
October 2024
Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009.
For the past 20 years, transcatheter aortic valve replacement (TAVR) has been the treatment of choice for symptomatic aortic stenosis. The transfemoral (TF) access is considered the gold standard approach for TAVR. However, TF-TAVR cannot be performed in some patients; thus, alternative accesses are required.
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