title: Alternative transarterial access for CoreValve transcatheter aortic bioprosthesis implantation.
abstract: Transcatheter aortic valve implantation (TAVI) is used to treat elderly patients with severe aortic stenosis who are considered extremely high-risk surgical candidates. The safety and effectiveness of TAVI have been demonstrated in numerous studies. The self-expanding CoreValve bioprosthesis (Medtronic Inc., Minneapolis, MN, USA) was the first transcatheter aortic valve to be granted the Conformité Européene (CE) mark in May 2007 for retrograde transfemoral implantation. However, TAVI patients are also often affected by severe iliofemoral arteriopathy. In these patients, the retrograde transfemoral approach carries a high risk of vascular injury, making this approach unusable. Alternative arterial access sites, such as the subclavian artery, the ascending aorta, and the carotid artery, have been used for retrograde implantation of the CoreValve bioprosthesis. In the present report, we present the procedural considerations, risks, and benefits of the different types of arterial access used to implant the CoreValve bioprosthesis.
authors: 'A. De Gasperis' Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Piazza dell'Ospedale Maggiore 3, 20162 Milan, Italy.
authors: Giuseppe
authors: G
authors: Bruschi
authors: Federico
authors: F
authors: De Marco
authors: Thomas
authors: T
authors: Modine
authors: Luca
authors: L
authors: Botta
authors: Paola
authors: P
authors: Colombo
authors: Silvia
authors: S
authors: Mauri
authors: Aldo
authors: A
authors: Cannata
authors: Pasquale
authors: P
authors: Fratto
authors: Silvio
authors: S
authors: Klugmann
mesh_terms: D001011:Aorta / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D002339:Carotid Arteries / Q000601:surgery; D017023:Coronary Angiography; D004452:Echocardiography; D004867:Equipment Design; D005269:Femur / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D013348:Subclavian Artery / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: CoreValve; aortic stenosis; catheter-based valve intervention; structural heart disease; transcatheter technique