Transaxillary transcatheter ACURATE neo aortic valve implantation - The TRANSAX multicenter study

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Surgical Innovation

Background:

• Transcatheter aortic valve replacement (TAVR) via the transaxillary (TAx) approach using the ACURATE neo valve is an off-label procedure.
• Limited data exists on the outcomes of this specific TAVR technique.

Purpose of the Study:

• To gather and report major outcomes of ACURATE neo valve implantation via the TAx approach.
• To evaluate the safety and efficacy of this off-label TAVR procedure.

Main Methods:

• Retrospective analysis of 75 patients undergoing TAx TAVR with ACURATE neo valve across nine European and North American centers.
• Pre-specified 1-year follow-up obtained for all patients.
• Data collection included procedural details, complications, and mortality rates.

Main Results:

• High procedural success rate (96%) with low rates of severe complications.
• Cardiac tamponade occurred in 2.7% of cases; 1.3% required conversion to open surgery.
• In-hospital (2.7%) and 1-year mortality (8%) were comparable across different procedural settings.

Conclusions:

• TAx TAVR with the ACURATE neo valve is a feasible and effective off-label procedure.
• The study demonstrated a high success rate and low mortality, supporting its potential clinical utility.
• Further research may explore optimizing patient selection and procedural techniques.