Transcarotid Route: the Ideal Alternative Access for TAVI?
DOI: 10.4244/EIJ-D-18-01192
Jean-Philippe Verhoye1; Reda Belhaj Soulami2; Jacques Tomasi3; Dario Di Perna4; Guillaume Leurent5; Sebastien Rosier6; Sebastien Biedermann7; Amedeo Anselmi8;
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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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.
