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Review
. 2023 Feb 8;12(4):1342.
doi: 10.3390/jcm12041342.

New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023

Ana Paula Tagliari  1   2 , Maurizio Taramasso  3
Affiliations
Review

New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023

Ana Paula Tagliari et al. J Clin Med. .

Abstract

Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious sedation, and the avoidance of invasive lines becoming the new standards. Here, we discuss the minimalist TAVI approach and how we incorporate it into our current clinical practice.

Keywords: conscious sedation; minimalist approach; transcatheter aortic valve implantation; transcatheter aortic valve replacement; trends.

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Conflict of interest statement

Tagliari A.P. has received a Research Grant from CAPES–Brazil (Finance Code 001) and has received a speaking fee from Biotronik. Taramasso M. has been a consultant or the recipient of consultancy fees from Abbott, Edwards Lifesciences, Boston Scientific, Shenqi Medical, CoreMedic, 4tech, Simulands, MTEx, Cardiovalve, and MEDIRA.

Figures

Figure 1
Figure 1
The main steps of a minimalist TAVI approach.
Figure 2
Figure 2
3M TAVI clinical pathway adapted from Wood DA et al. [7]. CBC = complete blood count; ECG = electrocardiogram; eGFR = estimated glomerular filtration rate; IV = intravenous; PA = pulmonary artery; POD1 = post-operative day 1; Q15 = every 15 min; Q30 = every 30 min; TTE = transthoracic echocardiography.
Figure 3
Figure 3
Eligibility criteria for the “PCI-like” approach. Adapted from Denimal T et al. [16].
Figure 4
Figure 4
Minimalist TAVI peri-procedure considerations.
See this image and copyright information in PMC

References

    1. Cribier A., Eltchaninoff H., Bash A., Borenstein N., Tron C., Bauer F., Derumeaux G., Anselme F., Laborde F., Leon M.B. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation. 2002;106:3006–3008. - PubMed
    1. Sawan M.A., Calhoun A.E., Grubb K.J., Devireddy C.M. Update on Minimalist TAVR Care Pathways: Approaches to Care in 2022. Curr. Cardiol. Rep. 2022;24:1179–1187. doi: 10.1007/s11886-022-01737-x. - DOI - PMC - PubMed
    1. Leclercq F., Meunier P.A., Gandet T., Macia J.C., Delseny D., Gaudard P., Mourad M., Schmutz L., Robert P., Roubille F., et al. Simplified TAVR Procedure: How Far Is It Possible to Go? J. Clin. Med. 2022;11:2793. doi: 10.3390/jcm11102793. - DOI - PMC - PubMed
    1. Lauck S.B., Wood D.A., Baumbusch J., Kwon J.Y., Stub D., Achtem L., Blanke P., Boone R.H., Cheung A., Dvir D., et al. Vancouver Transcatheter Aortic Valve Replacement Clinical Pathway: Minimalist Approach, Standardized Care, and Discharge Criteria to Reduce Length of Stay. Circ. Cardiovasc. Qual. Outcomes. 2016;9:312–321. doi: 10.1161/CIRCOUTCOMES.115.002541. - DOI - PubMed
    1. Sola M., Ramm C.J., Kolarczyk L.M., Teeter E.G., Yeung M., Caranasos T.G., Vavalle J.P. Application of a Multidisciplinary Enhanced Recovery After Surgery Pathway to Improve Patient Outcomes After Transcatheter Aortic Valve Implantation. Am. J. Cardiol. 2016;118:418–423. doi: 10.1016/j.amjcard.2016.05.015. - DOI - PubMed

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