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Right transaxillary transcatheter aortic valve replacement is comparable to left despite challenges.
McGrath, Daniel; Lee, Hansuh; Sun, Charley; Kawabori, Masashi; Zhan, Yong.
Afiliación
  • McGrath D; Tufts University School of Medicine, Boston, MA, USA.
  • Lee H; Tufts University School of Medicine, Boston, MA, USA.
  • Sun C; Tufts University School of Medicine, Boston, MA, USA.
  • Kawabori M; Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA.
  • Zhan Y; Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA. yong.zhan@tuftsmedicine.org.
Gen Thorac Cardiovasc Surg ; 72(10): 641-648, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38460099
ABSTRACT

OBJECTIVES:

Transaxillary access is the most popular alternative to transfemoral transcatheter aortic valve replacement. Although left transaxillary access is generally preferred, right transaxillary transcatheter aortic valve replacement could be challenging because of the opposing axillary artery and aortic curvatures, which may warrant procedural modifications to improve alignment. Our aim is to compare our single center's outcomes for left and right transaxillary access groups and to evaluate procedural modifications for facilitating right transaxillary transcatheter aortic valve replacement.

METHODS:

Patient characteristics and outcomes were compared for consecutive left or right axillary TAVRs performed from 6/2016 to 6/2022 with SAPIEN 3. The effects of our previously reported "flip-n-flex" technique on procedural efficiency and new conduction disturbances were subanalyzed in the right axillary group.

RESULTS:

Right and left transaxillary transcatheter aortic valve replacement were performed in 25 (18 with the "flip-n-flex" technique) and 26 patients, respectively. There were no significant differences between patient characteristics or outcomes. Right axillary subanalysis showed the "flip-n-flex" technique group had significantly shorter fluoroscopy times (21.2 ± 6.2 vs 29.6 ± 12.4 min, p = 0.03) and a trend towards less permanent pacemaker implantation (6.3% vs. 42.9%, p = 0.07) compared to the group without "flip-n-flex".

CONCLUSIONS:

In our study, despite anatomical challenges, right transaxillary transcatheter aortic valve replacement is comparable to left access. The "flip-n-flex" technique advances right transaxillary as an appealing access for patients with few options.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Estenosis de la Válvula Aórtica / Arteria Axilar / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Estenosis de la Válvula Aórtica / Arteria Axilar / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Japón