An Optimized Approach for Transfemoral Transcatheter Aortic Valve Implantation: A Comprehensive Review and Current Evidence

Yasuhiro Ichibori; Rishi Puri; Maurizio Taramasso; Fabian Nietlispach; Guilherme F Attizzani; Bernhard Meier; Vincent Auffret; Hervé Le Breton; Joao L Cavalcante; Rajiv Das; Deepak L Bhatt; Samir R Kapadia; Ankur Kalra

doi:10.1016/j.carrev.2019.12.032

An Optimized Approach for Transfemoral Transcatheter Aortic Valve Implantation: A Comprehensive Review and Current Evidence

Cardiovasc Revasc Med. 2020 Aug;21(8):1034-1040. doi: 10.1016/j.carrev.2019.12.032. Epub 2020 Jan 7.

Authors

Affiliations

¹ The Valve & Structural Heart Disease Intervention Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH, USA; Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
² Department of Cardiovascular Medicine, Cleveland Clinic, OH, USA; Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, OH, USA.
³ Department of Cardiac Surgery, University Hospital Zurich, Switzerland.
⁴ Department of Cardiology, University Hospital Zurich, Switzerland.
⁵ The Valve & Structural Heart Disease Intervention Center, Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH, USA.
⁶ Department of Cardiology, University Hospital Bern, Switzerland.
⁷ Department of Cardiology, Rennes University Hospital, Rennes, France.
⁸ Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.
⁹ Department of Cardiology, Freeman Hospital, Newcastle-upon-Tyne, UK.
¹⁰ Brigham and Women's Hospital, Heart and Vascular Center, Harvard Medical School, Boston, MA, USA.
¹¹ Department of Cardiovascular Medicine, Cleveland Clinic, OH, USA.
¹² Department of Cardiovascular Medicine, Cleveland Clinic, OH, USA. Electronic address: kalraa@ccf.org.

PMID: 31992532
DOI: 10.1016/j.carrev.2019.12.032

Abstract

Device iterations and technical refinements have enabled transcatheter aortic valve implantation (TAVI) to be offered as a routine interventional procedure in many centers with high reproducibility and success. The concept of a streamlined procedure with appropriate procedural optimization, namely "optimized approach," has become increasingly relevant, aimed at minimizing perioperative burden and promoting early recovery. Relatively high device costs may be mitigated by reducing length of hospital stay and resource utilization. This review summarizes current evidence of components related to the optimization process during transfemoral TAVI. It is important to customize the procedure specific to each patient for its optimization.

Keywords: Minimalist approach; Optimized approach; Transcatheter aortic valve implantation.

Publication types

Review

MeSH terms

Aortic Valve / diagnostic imaging
Aortic Valve / physiopathology
Aortic Valve / surgery*
Catheterization, Peripheral* / adverse effects
Evidence-Based Medicine
Femoral Artery*
Heart Valve Diseases / diagnostic imaging
Heart Valve Diseases / physiopathology
Heart Valve Diseases / surgery*
Humans
Patient Safety
Postoperative Complications / etiology
Punctures
Risk Assessment
Risk Factors
Transcatheter Aortic Valve Replacement* / adverse effects
Treatment Outcome