Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

ISSN: 1875-6557 (Online)
ISSN: 1573-403X (Print)


Volume 10, 4 Issues, 2014


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Current Cardiology Reviews

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Editor-in-Chief:
Fei Lu
University of Minnesota Medical School
Minneapolis, MN 55455
USA


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Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

Author(s): S. Bleiziffer, M. Krane, M.A. Deutsch, Y. Elhmidi, N. Piazza, B. Voss and R. Lange

Affiliation: Clinic for Cardiovascular Surgery, German Heart Center Munich, Lazarettstr. 36, 80636 Munich, Germany.

Abstract

TAVI (transcatheter aortic valve implantation) is a less invasive treatment of the stenotic aortic valve while avoiding midline sternotomy and cardiopulmonary bypass. A crimped biological valve on a self-expanding or balloonexpandable stent is inserted antegradely or retrogradely under fluoroscopy, and deployed on the beating heart. Among the worldwide TAVI programs, many different concepts have been established for the choice of the access site. Whether retrograde or antegrade TAVI should be considered the superior approach is matter of an ongoing debate. The published literature demonstrates safety of all techniques if performed within a dedicated multidisciplinary team. Since there is no data providing evidence if one approach is superior to another, we conclude that an individualized patient-centered decision making process is most beneficial, taking advantage of the complementarity of the different access options. The aim of this article is to give an overview of the current practice of access techniques for transcatheter based valve treatment and to outline the respective special characteristics.

Keywords: Transcatheter valve implantation, transapical, transfemoral, subclavian, transaortic.

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Article Details

Volume: 9
Issue Number: 4
First Page: 268
Last Page: 273
Page Count: 6
DOI: 10.2174/1573403X09666131202123326
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