Department of Anesthesia, Unidade Local de Saúde de Matosinhos - Hospital Pedro Hispano, Matosinhos, Portugal.
Department of Anesthesia, Centro Hospitalar de Vila Nova de Gaia/Espinho - Vila Nova de Gaia, Portugal.
Port J Card Thorac Vasc Surg. 2021 Jul 2;28(2):49-57. doi: 10.48729/pjctvs.169.
The transaxillary (TAX) approach for transcatheter aortic valve implantation (TAVI) results in comparable short and long-term clinical results compared to the transfemoral (TF) approach. However, adequate closure of the axillary artery is the most critical issue when performing the percutaneous approach. Compared to surgical transaxillary approach, the percutaneous approach was used only in selected cases due to this closure limitation. In the present paper, we aim to demonstrate the feasibility of implanting the CoreValve Evolut Pro transcatheter heart valve via percutaneous transaxillary approach and make a literature review of procedure particularities and outcome. We describe the case of a patient with severe aortic stenosis in the presence of small calibre and severely calcified femoral arteries. A CoreValve Evolut Pro 26 was successfully implanted percutaneously through the left axillary artery. Percutaneous transaxillary transcatheter aortic valve implantation is a feasible and safe alternative in patients who have suboptimal iliofemoral vessels.
经腋动脉(TAX)入路行经导管主动脉瓣置换术(TAVI)的短期和长期临床结果与经股动脉(TF)入路相似。然而,当进行经皮入路时,腋动脉的充分闭合是最关键的问题。与外科经腋动脉入路相比,由于这种闭合限制,仅在选定的情况下使用经皮入路。在本文中,我们旨在证明通过经皮经腋动脉入路植入 CoreValve Evolut Pro 经导管心脏瓣膜的可行性,并对手术特点和结果进行文献回顾。我们描述了一名患有严重主动脉瓣狭窄的患者,其股动脉口径小且严重钙化。通过左腋动脉成功地经皮植入了一个 26 号 CoreValve Evolut Pro。对于髂股血管条件不佳的患者,经皮经腋动脉经导管主动脉瓣植入术是一种可行且安全的替代方法。