Alternative Access for TAVR: A State-of-the-Art Review and Practical Guide. [Review]
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All Authors
Feistritzer, HJ.
Dumpies, O.
Rosseel, L.
Mylotte, D.
Rogers, T.
Blackman, DJ.
Sawaya, F.
Modine, T.
Palmerini, T.
Thiele, H.
LTHT Author
Blackman, Daniel
LTHT Department
Cardio-Respiratory
Cardiology
Cardiology
Non Medic
Publication Date
2025
Item Type
Journal Article
Review
Review
Language
Subject
Subject Headings
Abstract
Current guideline recommendations for transcatheter aortic valve replacement are largely confined to procedures performed via transfemoral (TF) access. Major advances in preprocedural planning, delivery system technology, and procedural technique have led to substantial growth in TF access, even in complex vascular anatomies. However, determining the threshold beyond which TF access is either not feasible or carries unacceptable risk remains controversial. Furthermore, although alternative transvascular access routes have largely replaced surgical transthoracic approaches in patients unsuitable for TF access, the optimal alternative access route is still debated. Herein, the authors provide a state-of-the-art review of alternative access for TAVR, including the decision-making process between TF and non-TF approaches and the key elements of alternative access site selection and execution.
Journal
Jacc: Cardiovascular Interventions