Supraclavicular Subclavian access for Sapien Transcatheter aortic valve replacement- a novel approach

J Cardiothorac Surg. 2018 Jan 30;13(1):16. doi: 10.1186/s13019-018-0706-9.

Abstract

Background: Within the trans-subclavian approach, procedural techniques can vary widely, and reported access generally refers to an infraclavicular axillary approach. We describe and report the use of a novel supraclavicular true subclavian approach for transcatheter aortic valve replacement (TAVR) exclusively for implantation of Sapien 3 valves.

Case presentation: We report our first five consecutive patients undergoing TAVR with a Sapien 3 valve using a standardized subclavian approach at a single center. In-hospital and 30-day complications were reported. The use of this approach resulted in successful implantation in 100% of patients in a safe manner with 0% mortality, stroke, and vascular injury during hospitalization and at 30 day follow-up. The in-hospital pacemaker implantation rate was 20%. The average length of stay was 3 days.

Conclusions: TAVR with Sapien implant can be safely performed with a standardized supraclavicular subclavian approach in patients with unfavorable femoral access.

Keywords: Aortic; Sapien; Subclavian; Supraclavicular; Transcatheter.

MeSH terms

  • Aged, 80 and over
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / surgery
  • Female
  • Heart Valve Prosthesis
  • Humans
  • Length of Stay
  • Male
  • Postoperative Complications
  • Subclavian Vein / surgery*
  • Transcatheter Aortic Valve Replacement / adverse effects
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome