A comparison of alternative access routes for transcatheter aortic valve implantation

Overtchouk, Pavel; Modine, Thomas

Document type :

Article dans une revue scientifique: Article original

DOI :

10.1080/14779072.2018.1524295

PMID :

30232918

Permalink :

http://hdl.handle.net/20.500.12210/15834

Title :

A comparison of alternative access routes for transcatheter aortic valve implantation

Author(s) :

Overtchouk, Pavel [Auteur]
Modine, Thomas [Auteur]

Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]

Journal title :

Expert review of cardiovascular therapy

Abbreviated title :

Expert Rev Cardiovasc Ther

Publication date :

2018-09-20

ISSN :

1744-8344

English keyword(s) :

transaortic
TAVR
TAVI
transcaval
transsubclavian
transcarotid
transapical
Alternative

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Alternative transcatheter aortic valve implantation (TAVI) approaches offer the possibility of valve replacement in patients ineligible to the transfemoral route. Authors provide an updated review of the existing ...
Show more >BACKGROUND: Alternative transcatheter aortic valve implantation (TAVI) approaches offer the possibility of valve replacement in patients ineligible to the transfemoral route. Authors provide an updated review of the existing alternative approaches. Areas covered: A systematic review of alternative approaches for TAVI was undertaken. The feasibility, safety, efficacy, and technical requirements of the transapical, transaortic, transcarotid, transsubclavian, and transcaval approaches have been compared. A multislice computed tomography is often necessary for pre-operative planning. Although the first developed, the transapical pathway tends to be abandoned because of its high morbidity. Transaortic approach requires a mini-sternotomy or thoracotomy and general anesthesia limiting its' acceptance. Transcarotid approach requires a mini-invasive surgical cutdown but is feasible under conscious sedation. Registry data provided reassurance regarding the stroke risk with the transcarotid approach. Transsubclavian pathway is recent and feasible percutaneously although necessitates additional complex maneuvers to avoid serious bleeding complications, which extends its' learning curve. Transcaval approach is still experimental but may benefit from technological advances. Expert commentary: The choice of the alternative approach dependents on patient anatomy and comorbidities, and local operator expertise and skills. Transaortic, transcarotid and transsubclavian are nowadays used the most. However, comparative data to favor one approach over another is lacking and further research is warranted.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

Lille Neurosciences & Cognition (LilNCog) - U 1172

Research team(s) :

Troubles cognitifs dégénératifs et vasculaires

Submission date :

2019-11-27T13:01:40Z

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