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Review
. 2022 May 16;11(10):2793.
doi: 10.3390/jcm11102793.

Simplified TAVR Procedure: How Far Is It Possible to Go?

Florence Leclercq  1 , Pierre Alain Meunier  1 , Thomas Gandet  2 , Jean-Christophe Macia  1 , Delphine Delseny  1 , Philippe Gaudard  2 , Marc Mourad  2 , Laurent Schmutz  3 , Pierre Robert  3 , François Roubille  1   4 , Guillaume Cayla  3 , Mariama Akodad  1
Affiliations
Review

Simplified TAVR Procedure: How Far Is It Possible to Go?

Florence Leclercq et al. J Clin Med. .

Abstract

Increasing operators' experience and improvement of the technique have resulted in a drastic reduction in complications following transcatheter aortic valve replacement (TAVR) in patients with lower surgical risk. In parallel, the procedure was considerably simplified, with a routine default approach including local anesthesia in the catheterization laboratory, percutaneous femoral approach, radial artery as the secondary access, prosthesis implantation without predilatation, left ventricle wire pacing and early discharge. Thus, the "simplified" TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety. The minimalist strategy must not become dogmatic and careful pre-, per- and post-procedural evaluation of patients with well-defined protocols guarantee optimal care following TAVR. This review aims to evaluate the benefits and limits of the simplified TAVR procedure in a current and future vision.

Keywords: TAVR; simplification; tailored approach.

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Conflict of interest statement

F.L. received research grants from Edwards, Medtronic and Boehringer; consultant fees from Boehringer; and lecture fees from Astra Zeneca and Bayer. G.C. has received research grants/consultant fees/lectures fees from Amgen, AstraZeneca, Abbott, Bayer, Biotronik, Bristol-Myers Squibb, Pfizer and Sanofi-Aventis. M.A. received research grants from Federation Française de Cardiologie, MUSE-explore, Villa M, Edwards Lifescience, Medtronic and Biotronik. P.R. received research grants from Edwards Lifescience.

Figures

Figure 1
Figure 1
TAVI procedure simplification strategy: desirable or not.
See this image and copyright information in PMC

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