The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Transcarotid Route: the Ideal Alternative Access for TAVI?

1. Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
2. Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
3. Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
4. Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
5. Division of Cardiology, Pontchaillou University Hospital, Rennes, France
6. Division of Cardiac Anesthesia, Pontchaillou University Hospital, Rennes, France
7. Division of Cardiac Anesthesia, Pontchaillou University Hospital, Rennes, France
8. Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France, Rennes, FRANCE
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As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers. To read the full content of this article, please download the PDF.

Aims:. To evaluate a single-center experience with the transcarotid access for TAVI based on VARC-2 definitions.

Methods and results:. Fifty successive patients undergoing transcarotid TAVI were included. Locoregional anesthesia was used in 64% of cases. There was no early mortality and one case of stroke (2%). Vascular access-related (all minor) complications occurred in 4% of patients; average hospital stay was 4.6 ± 3.2 days. Device success was adjudicated in 92% of cases, early safety in 96%, and clinical success in 92%.

Conclusions:. The transcarotid route for TAVI is reproducible and associated with low rates of adverse neurological events, access-related complications and bleeding complications. Routine use of locoregional anesthesia is feasible. Careful surgical management of the common carotid artery is pivotal.

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