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

Amedeo Anselmi (1, 2) , Jacques Tomasi (1, 2) , Francesco Giardinelli (2) , Marc Bedossa (3) , Sebastien Rosier (3) , Jean Philippe Verhoye (1, 2)

1 LTSI - Laboratoire Traitement du Signal et de l'Image
2 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
3 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]

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.

Domaines: Cardiologie et système cardiovasculaire; Ingénierie biomédicale

Amedeo Anselmi, Jacques Tomasi, Francesco Giardinelli, Marc Bedossa, Sebastien Rosier, et al.. Safety and effectiveness of the transsubclavian approach for transcatheter aortic valve implantation with the 14-F CoreValve Evolut R device. Journal of Cardiovascular Medicine, 2018, 19 (11), pp.664-668. ⟨10.2459/JCM.0000000000000706⟩. ⟨hal-01902638⟩