Safety and effectiveness of the transsubclavian approach for transcatheter aortic valve implantation with the 14-F CoreValve Evolut R device

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Abstract

Aims

In addition to the transfemoral route, common approaches for transcatheter aortic valve implantation (TAVI) are the transapical and transaortic ones. Yet, these are associated with morbidity. The transsubclavian approach (TSA) is an alternative to minimize invasiveness.

Methods

Fifteen consecutive patients underwent TAVI via TSA using the CoreValve Evolut R. The 14F delivery system without sheath was directly introduced into the artery.

Results

Success was 100%; contrast volume was 99.4 ± 29.58 ml. Patients were extubated after 1.66 ± 0.89 h. Hemoglobin drop was 0.64 ± 0.28 g/dl. There were no complications. Hospital stay was 4.53 ± 1.24 days: 11 patients were discharged home, the remainder to rehabilitation.

Conclusion

TSA is associated with limited morbidity, early patient mobilization, short hospitalization.

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