Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy.
Department of Cardiology, University Campus Biomedico of Rome, Via Alvaro del Portillo 200, 00133 Rome, Italy.
Int J Environ Res Public Health. 2022 Jul 16;19(14):8649. doi: 10.3390/ijerph19148649.
The aim of our study was to determine the feasibility and efficacy of transaxillary (TAX) TAVI in patients not eligible for the transfemoral route. 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. In the TAX groups, we found a higher prevalence of men ( = 0.001), smokers ( = 0.033), and previous strokes ( = 0.02). The EUROSCORE II was higher in the TAX group ( = 0.014). The success rate of the device was 100%. TAX was associated with a longer procedure time ( = 0.001) and shorter median device time ( = 0.034) in minutes. Patients treated with TAX had a longer hospital stay ( = 0.005) and higher overall bleeding rate ( = 0.001). Peripheral neurological complications were more frequent with TAX ( = 0.001), which almost completely resolved by 30 days. TAX TAVI is safe and effective and should be considered as a second choice when transfemoral TAVI is not feasible due to severe comorbidities.
我们的研究目的是确定经锁骨下（TAX）入路在不适合经股动脉入路的患者中行 TAVI 的可行性和疗效。这是一项单中心回顾性研究。我们分析了 262 例行 TAVI 的患者。在 17 名患者（6.5%）中，采用 TAX 方法进行了该程序。评估并比较了经股动脉和 TAX 组之间的手术和住院数据、30 天安全性和临床疗效。在 TAX 组中，我们发现男性（=0.001）、吸烟者（=0.033）和既往卒中（=0.02）的患病率较高。TAX 组的欧洲心脏手术风险评分 II（=0.014）更高。器械成功率为 100%。TAX 与更长的手术时间（=0.001）和更短的器械中位时间（=0.034）相关，均以分钟计。TAX 治疗的患者住院时间更长（=0.005），总出血率更高（=0.001）。TAX 后更常发生周围神经并发症（=0.001），但在 30 天内几乎完全缓解。TAX TAVI 是安全有效的，在因严重合并症而不适合经股动脉 TAVI 时，应考虑作为二线选择。
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