Axillary Artery Conduit Formation for Arterial Access During Transapical Transcatheter Aortic Valve Replacement. Issue 3 (19th March 2014)

• Record Type: Journal Article
• Authors: Saxena, Pankaj; Greason, Kevin L.; Suri, Rakesh M.; Pochettino, Alberto; Holmes, David R.; Rihal, Charanjit S.; Mathew, Verghese
• Is Part Of: Journal of cardiac surgery. Volume 29:Issue 3(2014:May)
• Page Start: 308
• Page End: 311
• Publication Date: 2014-03-19
• Subjects: Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.12326
• Languages: English
• ISSNs: 0886-0440

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jocs12326-sec-0001" sec-type="section"> <title>Background</title> <p>Transapical transcatheter valve replacement is a relatively new technique for select patients with aortic valve stenosis, most of whom have severe peripheral vascular disease. We report our experience with the use of a right axillary artery conduit for arterial access during transapical valve replacement.</p> </sec> <sec id="jocs12326-sec-0002" sec-type="section"> <title>Methods</title> <p>We reviewed the records of 129 patients who underwent transapical transcatheter aortic valve replacement between November 2009 and August 2013. The study group included 26 (20.2%) patients who received a right axillary artery conduit for arterial access. Median age of the patients was 84 years (63 to 90), sex was female in seven (26.9%), and Society of Thoracic Surgeons predicted risk of mortality was 8.7% (1.8 to 21.2).</p> </sec> <sec id="jocs12326-sec-0003" sec-type="section"> <title>Results</title> <p>Axillary artery conduit use was significantly more common during the first half of our operative experience (24/65 patients, 36.9%) in comparison to the second half (2/64 patients, 3.1%; p < 0.0001)<monospace>.</monospace> Inadequate iliofemoral artery diameter for cardiopulmonary bypass support was present in six patients (23.1%) who received a conduit. All patients underwent successful placement of the axillary artery conduit and subsequent conduit access for catheter‐based procedures. Cardiopulmonary bypass support was provided to five (19.2%) patients. Operative mortality occurred in three (11.5%) patients and complications in 12 (46.2%), neither of which were related to the axillary artery conduit.</p> </sec> <sec id="jocs12326-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Creation of an axillary artery conduit provides a safe arterial access platform for transapical transcatheter aortic valve replacement. doi: 10.1111/jocs.12326 <italic>(J Card Surg 2014;29:308–311)</italic></p> </sec> </abstract>