Related Experiment Video
Updated: Nov 26, 2025
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
384
A step-by-step guide to trans-axillary transcatheter aortic valve replacement
Morgan T Harloff1, Edward D Percy1, Sameer A Hirji1
1Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Annals of Cardiothoracic Surgery
|December 14, 2020
Summary
Transcatheter aortic valve replacement (TAVR) via the axillary artery (TAx) offers a less invasive alternative when transfemoral access is not feasible. This approach bypasses the need for thoracic entry, utilizing familiar surgical techniques.
Area of Science:
- Cardiovascular Interventions
- Minimally Invasive Surgery
- Structural Heart Disease
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis, requiring large-bore catheter access.
- Transfemoral (TF) access is preferred, but alternative routes are necessary for patients with unsuitable iliofemoral vessels.
Discussion:
- Trans-axillary TAVR (TAx-TAVR) provides a peripheral vascular access option, avoiding pericardial or thoracic cavity entry.
- The axillary artery approach utilizes surgical techniques familiar to cardiac surgeons.
- Advancements in TAVR technology are enabling totally percutaneous axillary access.
Key Insights:
- TAx-TAVR is a viable alternative for patients unsuitable for TF access.
- The procedure leverages established surgical familiarity with the axillary artery.
- Evolving TAVR systems facilitate less invasive percutaneous axillary access.
Outlook:
- Further research into patient selection, imaging, and procedural optimization for TAx-TAVR is warranted.
- Contemporary clinical outcomes for TAx-TAVR are being actively examined.
- The increasing adoption of TAx-TAVR reflects its growing importance in TAVR access strategies.
Keywords:
Tax-TAVRTranscatheter aortic valve replacement (TAVR)alternative accesstrans-axillary (TAx) TAVRMore Related Videos
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
561
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
561
01:16Tracheostomy Care I: Pre-procedural Steps
610
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
610