The Transaxillary Route as a Second Access Option in TAVI Procedures: Experience of a Single Centre

Saverio Muscoli, Valeria Cammalleri, Michela Bonanni, Francesca Romana Prandi, Angela Sanseviero, Gianluca Massaro, Marco Di Luozzo, Marcello Chiocchi, Andrea Ascoli Marchetti, Arnaldo Ippoliti, Alessia Zingaro, Gian Paolo Ussia, Francesco Romeo, Pasquale De Vico
International Journal of Environmental Research and Public Health 2022 July 16, 19 (14)
Background: The aim of our study was to determine the feasibility and efficacy of transaxillary (TAX) TAVI in patients not eligible for the transfemoral route. Methods: This is a retrospective study of a single center. We analysed 262 patients treated with TAVI. In 17 patients (6.5%), the procedure was performed with the TAX approach. Procedural and hospital data, 30-day safety, and clinical efficacy were assessed and compared between the transfemoral and TAX groups. Results: In the TAX groups, we found a higher prevalence of men ( p = 0.001), smokers ( p = 0.033), and previous strokes ( p = 0.02). The EUROSCORE II was higher in the TAX group ( p = 0.014). The success rate of the device was 100%. TAX was associated with a longer procedure time ( p = 0.001) and shorter median device time ( p = 0.034) in minutes. Patients treated with TAX had a longer hospital stay ( p = 0.005) and higher overall bleeding rate ( p = 0.001). Peripheral neurological complications were more frequent with TAX ( p = 0.001), which almost completely resolved by 30 days. Conclusions: TAX TAVI is safe and effective and should be considered as a second choice when transfemoral TAVI is not feasible due to severe comorbidities.

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