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Suprasternal transcatheter aortic valve replacement: Modified trocar-free technique
Guilherme C de Oliveira1, Julia Kessel2, John Vavalle3
1Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Journal of Cardiac Surgery
|November 15, 2022
Summary
A new trocar-free technique for transcatheter aortic valve replacement (TAVR) via the suprasternal approach offers a safe alternative for patients with unsuitable femoral arteries.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Transcatheter aortic valve replacement (TAVR) is the standard for severe aortic stenosis.
- The suprasternal approach is an alternative for patients with poor femoral access.
- Existing suprasternal techniques often utilize trocars.
Purpose of the Study:
- To describe a novel, trocar-free technique for TAVR using the suprasternal approach.
- To evaluate the safety and reproducibility of this new method.
Main Methods:
- The procedure involves an incision above the manubrium under endotracheal anesthesia.
- Dissection to the innominate artery allows for cannulation.
- The access site is closed with a purse-string suture.
Main Results:
- The trocar-free suprasternal TAVR technique was successfully described.
- The approach has limited contraindications.
- The technique is safe and reproducible.
Conclusions:
- The described trocar-free suprasternal technique provides a viable and safe option for TAVR.
- This method is particularly beneficial for patients with challenging femoral access.
