Modified transapical-transcatheter aortic valve implantation

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• High-grade aortic stenosis necessitates intervention, with transcatheter aortic valve implantation (TAVI) and surgery as primary options.
• Patients with extensive arterial disease and calcification present significant challenges for standard TAVI approaches.
• Comorbidities like porcelain aorta, Leriche syndrome, and prior vascular interventions further limit arterial access options.

Purpose of the Study:

• To present a modified transapical TAVI technique for patients unsuitable for transvascular TAVI due to severe panarteriopathy.
• To evaluate the safety and efficacy of the artery-no-touch transapical TAVI approach in a select patient cohort.

Main Methods:

• Modification of the standard transapical TAVI procedure to ensure an artery-no-touch technique.
• Application of the modified technique in patients with end-stage peripheral artery disease and no viable arterial access.
• Retrospective analysis of procedural outcomes and in-hospital complications.

Main Results:

• The modified artery-no-touch transapical TAVI was successfully employed in six patients.
• No procedural or in-hospital complications were observed in the treated patient group.
• This technique provides a viable solution for complex TAVI candidates with limited arterial access.

Conclusions:

• The modified artery-no-touch transapical TAVI is a safe and effective alternative for patients with severe arterial disease who cannot undergo conventional TAVI.
• This approach expands treatment options for high-risk aortic stenosis patients with challenging vascular anatomy.
• Further research may explore broader application and long-term outcomes of this modified TAVI technique.