The transcervical access for transcatheter aortic valve replacement.

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Medical Technology

Background:

• Transcatheter aortic valve replacement (TAVR) requires alternative access in patients with contraindications to transfemoral access.
• Existing alternative TAVR approaches like transaortic and transapical may necessitate thoracotomy.

Purpose of the Study:

• To present the transcervical approach as a viable alternative access for TAVR.
• To describe the surgical technique for transcervical access developed at the institution.

Main Methods:

• The transcervical approach accesses the aortic valve via supra-aortic vessels (brachiocephalic trunk, carotid, or subclavian artery).
• This technique avoids the need for thoracotomy.
• Surgical technique details for transcervical access are described.

Main Results:

• The transcervical approach avoids thoracotomy, a benefit over some alternative TAVR methods.
• Preliminary data suggest comparable periprocedural and 30-day outcomes to transfemoral access.
• Further clarification is needed on optimal anesthesia and access side.

Conclusions:

• The transcervical approach is a promising alternative access for TAVR in select patients.
• It offers a less invasive option compared to approaches requiring thoracotomy.
• This technique warrants further investigation and standardization.