Transcarotid Access For Tavr: An Emerging Technique For Both Balloon And Self-expanding Transcatheter Heart Valves
Keith Allen, Adnan Chhatriwalla, John Saxon, Chetan Huded, John Russell Davis, Anthony Hart, A. Michael Borkon.
St. Luke's Mid America Heart Institute, Kansas City, MO, USA.
OBJECTIVE: While transfemoral access for transcatheter aortic valve replacement (TAVR) can be used in most patients, the Heart Team should be familiar and comfortable with at least one non-femoral, non thoracic access. Transcarotid access has emerged as the primary non-femoral access for many Heart Teams and important technical aspects are worth learning to optimize outcomes.
METHODS: This video tutorial demonstrates the important technical aspects of performing transcarotid TAVR with both balloon and self-expanding transcatheter heart valves.
RESULTS: Transcarotid access is an efficient, safe technique that provides inexpensive embolic protection to the ipsilateral hemisphere during TAVR. Considering the increased stroke signal observed with axillary access, by the 4th quarter of 2020 transcarotid access had became the dominate non-femoral access according to the ACC/STS TVT Registry.
CONCLUSIONS: Transcarotid access has emerged as the dominate non-femoral access
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