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Multicenter Study
. 2018 Dec;106(6):e325-e327.
doi: 10.1016/j.athoracsur.2018.05.095.

Suprasternal and Left Axillary Transcatheter Aortic Valve Replacement in Morbidly Obese Patients

Anna Olds  1 , Kyle Eudailey  2 , Tamim Nazif  3 , Torsten Vahl  3 , Omar Khalique  3 , Clifton Lewis  2 , Rebecca Hahn  3 , Martin Leon  3 , Vinayak Bapat  1 , Mustafa Ahmed  4 , Susheel Kodali  3 , Isaac George  5
Affiliations
Multicenter Study

Suprasternal and Left Axillary Transcatheter Aortic Valve Replacement in Morbidly Obese Patients

Anna Olds et al. Ann Thorac Surg. 2018 Dec.

Abstract

In morbidly obese patients who cannot undergo transfemoral, transaortic, or transapical transcatheter aortic valve replacement (TAVR) due to body habitus, suprasternal (SS) and left subclavian/axillary artery (LSCLA) approaches may provide safe TAVR access. Nine morbidly obese patients with a body mass index of 35 or more underwent SS-TAVR (7 patients) or LSCLA-TAVR (2 patients) at two institutions from 2015 to 2017. Mean age was 69.4 ± 7.3 years, and mean body mass index was 50.3 ± 10.6. There were no deaths, valve reinterventions, or reoperations. Three patients required new pacemakers. In morbidly obese patients who are not candidates for the other approaches, SS-TAVR and LSCLA-TAVR allow easier vascular access and prevent the need for thoracotomy or sternotomy.

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Comment in

  • Does Type of TAVR Access Affect Early Mortality in Morbidly Obese Patients?
    Nappi F. Nappi F. Ann Thorac Surg. 2019 May;107(5):1583-1584. doi: 10.1016/j.athoracsur.2018.07.072. Epub 2018 Sep 27. Ann Thorac Surg. 2019. PMID: 30268532 No abstract available.
  • Reply.
    Olds A, George I. Olds A, et al. Ann Thorac Surg. 2019 May;107(5):1584. doi: 10.1016/j.athoracsur.2018.12.031. Epub 2019 Jan 23. Ann Thorac Surg. 2019. PMID: 30684478 No abstract available.

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