Abstract
Transcarotid transcatheter aortic valve replacement (TAVR) is a new alternative in
patients with contraindications to other approaches. We report results in 5 patients
who underwent TAVR using the common carotid artery approach. Intraprocedural evaluation
of the integrity of the circle of Willis was performed by measuring backflow pressure
and cerebral oximetry. All patients underwent successful TAVR, without any cerebrovascular
or access-related complications. Patient mobilization occurred early postprocedure
and 4 of the 5 patients were discharged 3 days after the TAVR procedure. In conclusion,
these results suggest that transcarotid access is a safe and feasible secondary TAVR
approach.
Résumé
Le remplacement d’une valve aortique par cathéter (RVAC) transcarotidien constitue
une nouvelle possibilité de traitement offerte aux patients chez qui les autres types
d’intervention sont contre-indiqués. Ce rapport porte sur cinq patients ayant subi
un RVAC par voie de l’artère carotide commune. Lors de l’intervention, l’intégrité
du cercle artériel de Willis a été évaluée en mesurant la pression sanguine de retour
et l’oxymétrie cérébrale. L’intervention a été un succès chez tous les patients et
aucun d’entre eux n’a subi de complications vasculaires cérébrales ou liées à la voie
d’accès. Tous les patients ont pu être mobilisés peu de temps après l’intervention,
et quatre des cinq patients ont reçu leur congé de l’hôpital après trois jours. En
conclusion, de tels résultats tendent à démontrer que l’intervention par voie transcarotidienne
constitue une option faisable et sécuritaire pour le RVAC.
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References
- Transcatheter aortic valve implantation through carotid artery access under local anaesthesia.Eur J Cardiothorac Surg. 2014; 46 ([discussion: 698]): 693-698
- Transcutaneous aortic valve implantation using the left carotid access: feasibility and early clinical outcomes.Ann Thorac Surg. 2012; 93: 1489-1494
- Aortic valve implantation with the CoreValve ReValving System via left carotid artery access: first case report.J Thorac Cardiovasc Surg. 2010; 140: 928-929
- Prospective randomized trial of routine versus selective shunting in carotid endarterectomy based on stump pressure.J Vasc Surg. 2010; 51: 1133-1138
- Noninvasive cerebral oxygenation may predict outcome in patients undergoing aortic arch surgery.J Thorac Cardiovasc Surg. 2011; 141: 815-821
Article info
Publication history
Published online: April 04, 2016
Accepted:
March 28,
2016
Received:
February 26,
2016
Footnotes
See page 1575.e12 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
