Facilitating right-sided axillary artery access for transcatheter aortic valve replacement using the Edwards Sapien 3 and ultra valves: Technical considerations.
Christopher A RajkumarChristopher CookJoseph ShalhoubAndrew ChukwuemekaUsman JafferNearchos HadjiloizouSayan SenNeil RupareliaGhada MikhailIqbal S MalikPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2019)
Trans-Axillary Transcatheter Aortic Valve Replacement (TAVR) has become established as the safest arterial approach when femoral arterial anatomy is unfavorable. Although a left sided axillary approach is generally preferred, patient specific factors may require use of the right axillary artery. In this case series we describe procedural modifications that are required to overcome the challenge of restricted space in the ascending aorta for in situ valve preparation of balloon-expandable valve systems when a right sided trans-Axillary approach is taken. These steps permit implantation of both the Edwards LifeSciences Sapien 3 and Ultra prostheses via the right trans-Axillary approach, allowing patients a greater range of valve options when this arterial route is required for TAVR.
Keyphrases
- transcatheter aortic valve replacement
- aortic valve
- aortic stenosis
- lymph node
- sentinel lymph node
- neoadjuvant chemotherapy
- transcatheter aortic valve implantation
- aortic valve replacement
- ultrasound guided
- ejection fraction
- early stage
- newly diagnosed
- locally advanced
- high resolution
- squamous cell carcinoma
- mass spectrometry
- coronary artery disease
- atrial fibrillation
- patient reported outcomes
- aortic dissection
- pulmonary arterial hypertension