Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) has become a widely adopted treatment modality for severe aortic stenosis. Transfemoral access is the approach of choice; however, approximately 25% of patients undergoing TAVR also have concomitant peripheral arterial disease. The recent advent of intra...

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Autores principales:	Eden C Payabyab, Lindsay S Elbaum, Navneet Sharma, Isaac George, Stephanie L Mick
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/0a088563731f4d06a49f29bb84c85a16
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spelling	oai:doaj.org-article:0a088563731f4d06a49f29bb84c85a162021-12-04T16:05:24ZShockwave and Non-transfemoral Transcatheter Aortic Valve Replacement10.15420/usc.2021.161758-390X1758-3896https://doaj.org/article/0a088563731f4d06a49f29bb84c85a162021-11-01T00:00:00Zhttps://www.uscjournal.com/articleindex/usc.2021.16https://doaj.org/toc/1758-3896https://doaj.org/toc/1758-390XTranscatheter aortic valve replacement (TAVR) has become a widely adopted treatment modality for severe aortic stenosis. Transfemoral access is the approach of choice; however, approximately 25% of patients undergoing TAVR also have concomitant peripheral arterial disease. The recent advent of intravascular lithotripsy has enabled preservation of transfemoral access in some patients; although, a proportion still require alternative, non-femoral access. Alternative access sites can be broadly categorized into transthoracic and peripheral, facilitated by surgical or percutaneous techniques. In this review, the technical details and clinical outcomes of various TAVR accesses are discussed. Initially, transthoracic approaches were most common, but recently, the trend has been toward alternative peripheral access due to superior outcomes. Although there are no randomized data to support all the alternative access sites, the experiences reported provide available options for a large portion of patients to be candidates for TAVR. The intervention site should be selected by a multidisciplinary heart team based on patient anatomical factors and institutional expertise.Eden C PayabyabLindsay S ElbaumNavneet SharmaIsaac GeorgeStephanie L MickRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENUS Cardiology Review , Vol 15, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Eden C Payabyab Lindsay S Elbaum Navneet Sharma Isaac George Stephanie L Mick Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
description	Transcatheter aortic valve replacement (TAVR) has become a widely adopted treatment modality for severe aortic stenosis. Transfemoral access is the approach of choice; however, approximately 25% of patients undergoing TAVR also have concomitant peripheral arterial disease. The recent advent of intravascular lithotripsy has enabled preservation of transfemoral access in some patients; although, a proportion still require alternative, non-femoral access. Alternative access sites can be broadly categorized into transthoracic and peripheral, facilitated by surgical or percutaneous techniques. In this review, the technical details and clinical outcomes of various TAVR accesses are discussed. Initially, transthoracic approaches were most common, but recently, the trend has been toward alternative peripheral access due to superior outcomes. Although there are no randomized data to support all the alternative access sites, the experiences reported provide available options for a large portion of patients to be candidates for TAVR. The intervention site should be selected by a multidisciplinary heart team based on patient anatomical factors and institutional expertise.
format	article
author	Eden C Payabyab Lindsay S Elbaum Navneet Sharma Isaac George Stephanie L Mick
author_facet	Eden C Payabyab Lindsay S Elbaum Navneet Sharma Isaac George Stephanie L Mick
author_sort	Eden C Payabyab
title	Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
title_short	Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
title_full	Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
title_fullStr	Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
title_full_unstemmed	Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement
title_sort	shockwave and non-transfemoral transcatheter aortic valve replacement
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/0a088563731f4d06a49f29bb84c85a16
work_keys_str_mv	AT edencpayabyab shockwaveandnontransfemoraltranscatheteraorticvalvereplacement AT lindsayselbaum shockwaveandnontransfemoraltranscatheteraorticvalvereplacement AT navneetsharma shockwaveandnontransfemoraltranscatheteraorticvalvereplacement AT isaacgeorge shockwaveandnontransfemoraltranscatheteraorticvalvereplacement AT stephanielmick shockwaveandnontransfemoraltranscatheteraorticvalvereplacement
_version_	1718372656628105216

Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement

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