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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Vascular management during transcatheter aortic valve replacement

Takahiro Tokuda1, Masanori Yamamoto2,3,4,

  • 1Department of Cardiology, Nagoya Heart Center, Nagoya, Aichi, Japan. tkhrtkd@yahoo.co.jp.

Cardiovascular Intervention and Therapeutics
|November 29, 2022
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) is standard therapy for aortic stenosis. This review covers TAVR vascular complications, focusing on prognosis, prevention, and management to reduce patient morbidity and mortality.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Transcatheter aortic valve replacement (TAVR) is a standard therapy for severe aortic valve stenosis, offering an alternative to open-heart surgery.
  • Proper vascular access management is crucial for TAVR procedures.
  • Vascular complications are a significant concern in TAVR due to large sheath use, irrespective of the access route.

Purpose of the Study:

  • To review vascular complications associated with TAVR procedures.
  • To summarize the prognosis, prevention strategies, and management of TAVR-related vascular complications.

Main Methods:

  • Literature review of TAVR procedures and associated vascular complications.
  • Analysis of different vascular access routes including transfemoral, transaxillary/subclavian, transcarotid, transapical, and transcaval approaches.
  • Synthesis of data on complication rates, outcomes, and management strategies.

Main Results:

  • The transfemoral approach is used in over 90% of TAVR cases.
  • Alternative access routes are necessary for patients unsuitable for the transfemoral approach.
  • Vascular complications remain a key challenge impacting TAVR outcomes.

Conclusions:

  • Effective management of vascular complications is essential to improve TAVR procedure safety.
  • Understanding complication risks, prevention, and management strategies can decrease morbidity and mortality.
  • Further research and standardized protocols are needed for optimal vascular access management in TAVR.

Keywords:
Transcatheter aortic valve replacement,Vascular complicationVascular managment,

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