A feasibility study of transaxillary TAVI with the lotus valve

Doshi, Sagar N.; George, Sudhakar; Kwok, Chun Shing; Mechery, Anthony; Mamas, Mamas A.; Ludman, Peter; Townend, Jonathan N.; Bhabra, Moninder

doi:10.1002/ccd.27409

Cited by 12 publications

(16 citation statements)

References 30 publications

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“…In total 193 articles were withheld, of which 18 were accepted for inclusion in this review [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Nine publications concern case series reporting on outcomes of transaxillary TAVI in either single (n = 6) [ 7 , 8 , 9 , 10 , 11 , 12 ] or multi-centre (n = 3) [ 13 , 14 , 15 ] studies.…”

Section: Resultsmentioning

confidence: 99%

The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes—A Systematic Review Article

Herremans,

Stevesyns,

El Jattari

et al. 2023

Rev. Cardiovasc. Med.

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Background: Transfemoral transcatheter aortic valve implantation (TAVI) has proven non-inferior or superior against surgical aortic valve replacement (SAVR) for patients at high, intermediate or low surgical risk. However, transfemoral access is not always feasible in patients with severely atherosclerotic or tortuous iliofemoral arteries. For these cases, alternative access techniques have been developed, such as transcarotid, transcaval, direct aortic or transaxillary access. In recent years, growing preference towards the transaxillary access has emerged. To provide a summary of data available on transaxillary TAVI and compare this approach to other alternative access techniques. Methods: A literature search was performed in PubMed by two independent reviewers. Studies reporting the outcome of at least 10 patients who underwent transaxillary TAVI, either in case series or in comparative studies, were included in this review. Articles not reporting outcomes according to the Valve Academic Research Consortium (VARC) 1–3 definitions were excluded. Results: In total 193 records were found of which 18 were withheld for inclusion in this review. This review reports on the combined data of the 1519 patients who underwent transaxillary TAVI. Procedural success was achieved in 1203 (92.2%) of 1305 cases. Life-threatening, major, and minor bleeding occurred respectively in 4.5% (n = 50 in 1112 cases), 12.9% (n = 143 in 1112 cases) and 8.8% (n = 86 in 978 cases). Major and minor vascular complications were reported in respectively 6.6% (n = 83 in 1256 cases) and 10.0% (n = 105 in 1048 cases) of patients. 30-day mortality was 5.2% (n = 76 out of 1457 cases). At one year follow-up, the mortality rate was 1% (n = 184 out of 1082 cases). Similar 30-day and 1-year mortality is observed in studies that compare with transaxillary, transfemoral or other alternative access techniques ( p 0.05). Conclusions: A wide application of transaxillary access as an alternative approach for TAVI has emerged. This technique has an excellent procedural success rate up to 92.0%, with low procedural complication rates. Clinical outcome of transaxillary TAVI is comparable to the other alternative TAVI approaches. However, these conclusions are solely based on observational data.

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Section: Resultsmentioning

confidence: 99%

The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes—A Systematic Review Article

Herremans,

Stevesyns,

El Jattari

et al. 2023

Rev. Cardiovasc. Med.

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“…1 displays the flow diagram for study search and selection. A total of 21 studies [12] , [13] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] including 75,995 unique patients who underwent TAVR (73,203 TF and 2,792 TSc/TAx) were included in the meta -analysis. All of the included studies were observational studies.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Abusnina¹,

Balakrishna²,

Ismayl³

et al. 2022

IJC Heart & Vasculature

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“…In total, 74 studies were screened for eligibility, and 22 studies met inclusion criteria and were included in the final analysis. 1,10,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]…”

Section: Search Resultsmentioning

confidence: 99%

“…This decision was made due to relevance with the clinical question being addressed, and to supplement the relatively small pTAX patient population in the existing published literature compared with sTAX. In total, 74 studies were screened for eligibility, and 22 studies met inclusion criteria and were included in the final analysis 1,10,15‐33 …”

Section: Methodsmentioning

confidence: 99%

Percutaneous large‐bore axillary access is a safe alternative to surgical approach: A systematic review

Southmayd

Hoque

Kaki

et al. 2020

Cathet Cardio Intervent

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Objectives: To systematically review relevant literature regarding cardiovascular outcomes of large-bore axillary arterial access via percutaneous and surgical approaches. Background: In patients with severe peripheral arterial disease (PAD) undergoing cardiac interventions, large-bore femoral access may be prohibitive. The axillary artery provides an alternative vascular access for transcatheter aortic valve replacement (TAVR) or mechanical circulatory support. There have been limited comparisons of percutaneous transaxillary (pTAX) approach with the more traditional surgical transaxillary (sTAX) approach. Methods: Pubmed and Medline databases were queried through January 2019 for studies describing pTAX or sTAX approaches with TAVR or Impella insertion. Primary outcomes were access-related mortality, 30-day mortality, stroke, major vascular complications, and major bleeding. Results: One hundred and fifty five studies were reviewed, with additional unpublished data from 1 institution. Twenty-two studies met the inclusion criteria. Patient data was heterogeneous, with 69% TAVR and 31% Impella use in the pTAX group, and 96% TAVR and 4% Impella use in the sTAX group. There was more cardiogenic shock in the pTAX group. When compared to surgical approach, the percutaneous approach had similar 30-day mortality for TAVR (5.6% vs 4.6%, OR nonsignificant) and Impella (43.4% vs 38.6%, OR non-significant), similar stroke rates (4.3% vs 4.2%, OR non-significant), similar major vascular complications (2.8% vs 2.3%, OR non-significant) and less major bleeding (2.7% vs 17.9%, OR significant). Conclusions: Data suggests large-bore pTAX access has similar 30-day mortality, stroke rates, and major vascular complications as sTAX access, with less major bleeding. Additional studies are needed to validate results.

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A feasibility study of transaxillary TAVI with the lotus valve

Cited by 12 publications

References 30 publications

The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes—A Systematic Review Article

The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes—A Systematic Review Article

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis

Percutaneous large‐bore axillary access is a safe alternative to surgical approach: A systematic review

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