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Updated: Jun 18, 2025
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Brachiocephalic Artery Access Without Sternotomy in Older Asian Patients Undergoing Transcatheter Aortic Valve
Takehiko Matsuo1,2, Takeshi Shimamoto1, Yasushi Fuku3
1Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan.
Abstract:
There are numerous approaches for transcatheter aortic valve replacement (TAVR); however, access-related complications remain a point of concern. We analyzed consecutive patients who underwent TAVR for severe aortic stenosis via the brachiocephalic artery (BCA) without sternotomy (TBc group, n = 10) and via the trans-ascending aortic (TAo group, n = 8). The median BCA diameter and distance between the access point and suprasternal notch or superior margin of the clavicle were 11.3 mm and 8.3 mm, respectively. No patients in the TBc group underwent a partial sternotomy. Compared with the TAo group, the TBc group exhibited a shorter mean procedure time and lower blood loss volume as well as shorter duration of hospitalization. TAVR through the BCA may be a safe and feasible alternative for ascending aorta access. Studies with longer follow-up analysis and more patients are warranted to confirm our findings.
