Carotid access in Transcatheter Aortic Valve Implantation – an alternative to the gold standard. A single-center experience
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Background: Transfemoral access is regarded as the TAVI gold standard for the transcatheter aortic valve implantation (TAVI) procedure. However, other options for vascular access have developed in the last few years. Access via the carotid artery is one such alternative. Materials and methods: The study included 9 elderly patients who underwent transcarotid TAVI procedure at the Cardiac and Vascular Surgery Department of the Medical University of Gdańsk. Procedures were performed by a local Heart Team in a hybrid operating room under general anesthesia. Data was collected before the implantation and at discharge. Results: The mean patients’ age was 81 years of age (64-88) and the mean logistic EuroSCORE was 10.8 (7-16). Implantations were performed with 100% device success rate. Intra-operative valve-in-valve procedure was performed in one patient; there were no access-related and valve-related complications during the surgery. Post-procedural complications included minor bleeding, hematoma and pneumothorax. Echocardiographic parameters were significantly improving after the procedure. The mean hospital stay was 5 days (2-7 days). Conclusions: Transcatheter aortic valve implantation via the carotid artery appears to be safe and effective alternative to standard TAVI vascular access.
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