title: Access Options for Transcatheter Aortic Valve Replacement in Patients with Unfavorable Aortoiliofemoral Anatomy.
abstract: In the current era, 10-15 % of transcatheter aortic valve replacement (TAVR)-eligible high and prohibitive risk patients with severe symptomatic aortic stenosis are not candidates for transfemoral arterial access. Knowledge of the various alternative access options can enable TAVR teams to provide improved quality of life and potentially life-saving treatment for a group of patients who otherwise have no viable options. In this article, we review approach to patients with unfavorable femoral arterial anatomy and provide an in-depth discussion on the various alternative routes for TAVR.
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Jayendrakumar S
authors.initials: JS
authors.lastname: Patel
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mick
authors.affiliation: Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. KAPADIS@ccf.org.|Cleveland Clinic, Sones Catheterization Laboratories, Mail Code J2-3, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. KAPADIS@ccf.org.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D001021:Aortic Valve / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D005263:Femoral Artery / Q000033:anatomy & histology / Q000473:pathology*; D005471:Fluoroscopy; D006350:Heart Valve Prosthesis; D006801:Humans; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Nontransfemoral access; TAVR