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Review
. 2023 Jan;38(1):18-27.
doi: 10.1007/s12928-022-00900-z. Epub 2022 Nov 29.

Vascular management during transcatheter aortic valve replacement

Affiliations
Review

Vascular management during transcatheter aortic valve replacement

Takahiro Tokuda et al. Cardiovasc Interv Ther. 2023 Jan.

Abstract

Transcatheter aortic valve replacement (TAVR), as an alternative to open heart surgery, has been established as the standard therapy for patients with severe aortic valve stenosis. Vascular access management, the first step in a TAVR procedure, should be managed properly. Moreover, the transfemoral and alternatives such as the transaxillary/subclavian, transcarotid, transapical, and transcaval approaches are considered access routes during TAVR. More than 90% of cases can be treated via the transfemoral approach in the current TAVR era, whereas other approaches should be considered in patients in whom the transfemoral approach is not suitable. Vascular complications regardless of access route differences are a specific issue of TAVR caused by the use of large sheaths. With the increased number of TAVR cases, we must manage vascular complications and decrease the morbidity and mortality rates associated with TAVR procedures. Thus, this study aimed to review the vascular complications during TAVR and summarize their prognosis, prevention, and adequate management.

Keywords: Transcatheter aortic valve replacement,; Vascular complication; Vascular managment,.

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References

    1. Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, Kapadia SR, Malaisrie SC, Cohen DJ, Pibarot P, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380:1695–705. - DOI
    1. Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O’Hair D, Bajwa T, Heiser JC, Merhi W, Kleiman NS, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med. 2019;380:1706–15. - DOI
    1. Walther T, Hamm CW, Schuler G, Berkowitsch A, Kotting J, Mangner N, Mudra H, Beckmann A, Cremer J, Welz A, et al. Perioperative results and complications in 15,964 transcatheter aortic valve replacements: prospective data from the GARY registry. J Am Coll Cardiol. 2015;65:2173–80. - DOI
    1. van Wiechen MP, Tchétché D, Ooms JF, Hokken TW, Kroon H, Ziviello F, Ghattas A, Siddiqui S, Laperche C, Spitzer E, et al. Suture- or plug-based large-bore arteriotomy closure: a pilot randomized controlled trial. JACC Cardiovasc Interv. 2021;14:149–57. - DOI
    1. Akodad M, Roubille F, Marin G, Lattuca B, Macia JC, Delseny D, Gandet T, Robert P, Schmutz L, Piot C, et al. Myocardial injury after balloon predilatation versus direct transcatheter aortic valve replacement: insights from the DIRECTAVI trial. J Am Heart Assoc. 2020;9: e018405. - DOI

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