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01.12.2018 | Case report | Ausgabe 1/2018 Open Access

Journal of Cardiothoracic Surgery 1/2018

Supraclavicular Subclavian access for Sapien Transcatheter aortic valve replacement- a novel approach

Zeitschrift:
Journal of Cardiothoracic Surgery > Ausgabe 1/2018
Autoren:
Thom G. Dahle, Nathaniel J. Castro, Brian M. Stegman, Jacob R. Dutcher, John M. Teskey, Wade T. Schmidt, Daren S. Danielson, Sara J. Dezell, Virginia B. Daniels, Daniel J. Tiede

Abstract

Background

Within the trans-subclavian approach, procedural techniques can vary widely, and reported access generally refers to an infraclavicular axillary approach. We describe and report the use of a novel supraclavicular true subclavian approach for transcatheter aortic valve replacement (TAVR) exclusively for implantation of Sapien 3 valves.

Case presentation

We report our first five consecutive patients undergoing TAVR with a Sapien 3 valve using a standardized subclavian approach at a single center. In-hospital and 30-day complications were reported. The use of this approach resulted in successful implantation in 100% of patients in a safe manner with 0% mortality, stroke, and vascular injury during hospitalization and at 30 day follow-up. The in-hospital pacemaker implantation rate was 20%. The average length of stay was 3 days.

Conclusions

TAVR with Sapien implant can be safely performed with a standardized supraclavicular subclavian approach in patients with unfavorable femoral access.
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