Transfemoral TAVI: Devices and Techniques

Chapter

Abstract

Trans-catheter aortic valve implantation (TAVI) has first been described with a trans-venous and trans-septal pathway by Cribier et al. [1], but it really expanded when the transfemoral arterial retrograde approach was described [2]. Ever since it has generated a tremendous enthusiasm in the interventional cardiology community and the industry. New prostheses, delivery systems, pathways, equipment, software and guidelines stemmed from this enthusiasm. Transfemoral TAVI has been favoured because of its low invasiveness and remains the first-choice pathway. In this chapter we will review the currently existing devices and techniques used for transfemoral TAVI, before reviewing some recent advances and results of this technique.

References

  1. 1.
    Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis. Circulation. 2002;106(24):3006–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Webb JG, Chandavimol M, Thompson CR, Ricci DR, Carere RG, Munt BI, et al. Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation. 2006;113(6):842–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Wynne DG, Rampat R, Trivedi U, de Belder A, Hill A, Hutchinson N, et al. Transradial Secondary Arterial Access for Transcatheter Aortic Valve Implantation: Experience and Limitations. Heart Lung Circ. 2015;24(7):682–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Allende R, Urena M, Cordoba JG, Ribeiro HB, Amat-Santos I, DeLarochellière R, et al. Impact of the use of transradial versus transfemoral approach as secondary access in transcatheter aortic valve implantation procedures. Am J Cardiol. 2014;114(11):1729–34.CrossRefPubMedGoogle Scholar
  5. 5.
    Schofer J, Colombo A, Klugmann S, Fajadet J, DeMarco F, Tchétché D, et al. Prospective multicenter evaluation of the direct flow medical transcatheter aortic valve. J Am Coll Cardiol. 2014;63(8):763–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Mehilli J, Jochheim D, Abdel-Wahab M, Rizas KD, Theiss H, Spenkuch N, et al. One-year outcomes with two suture-mediated closure devices to achieve access-site haemostasis following transfemoral transcatheter aortic valve implantation. EuroIntervention. 2016;12(10):1298–304.CrossRefPubMedGoogle Scholar
  7. 7.
    Kapadia SR, Kodali S, Makkar R, Mehran R, Lazar RM, Zivadinov R, et al. Protection against cerebral embolism during transcatheter aortic valve replacement. J Am Coll Cardiol. 2017;69(4):367–77.CrossRefPubMedGoogle Scholar
  8. 8.
    Rodés-Cabau J, Kahlert P, Neumann F-J, Schymik G, Webb JG, Amarenco P, et al. Feasibility and exploratory efficacy evaluation of the Embrella Embolic Deflector system for the prevention of cerebral emboli in patients undergoing transcatheter aortic valve replacement: the PROTAVI-C pilot study. JACC Cardiovasc Interv. 2014;7(10):1146–55.CrossRefPubMedGoogle Scholar
  9. 9.
    Haussig S, Mangner N, Dwyer MG, Lehmkuhl L, Lücke C, Woitek F, et al. Effect of a cerebral protection device on brain lesions following transcatheter aortic valve implantation in patients with severe aortic stenosis: the CLEAN-TAVI randomized clinical trial. JAMA. 2016;316(6):592–601.CrossRefPubMedGoogle Scholar
  10. 10.
    Vahanian A, Urena M, Walther T, Treede H, Wendler O, Lefèvre T, et al. Thirty-day outcomes in patients at intermediate risk for surgery from the SAPIEN 3 European approval trial. EuroIntervention. 2016;12(2):e235–43.CrossRefPubMedGoogle Scholar
  11. 11.
    Erkapic D, De Rosa S, Kelava A, Lehmann R, Fichtlscherer S, Hohnloser SH. Risk for permanent pacemaker after transcatheter aortic valve implantation: a comprehensive analysis of the literature. J Cardiovasc Electrophysiol. 2012;23(4):391–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Kodali S, Thourani VH, White J, Malaisrie SC, Lim S, Greason KL, et al. Early clinical and echocardiographic outcomes after SAPIEN 3 transcatheter aortic valve replacement in inoperable, high-risk and intermediate-risk patients with aortic stenosis. Eur Heart J. 2016;37(28):2252–62.CrossRefPubMedGoogle Scholar
  13. 13.
    Barbanti M, Petronio AS, Ettori F, Latib A, Bedogni F, De Marco F, et al. 5-year outcomes after transcatheter aortic valve implantation with corevalve prosthesis. JACC Cardiovasc Interv. 2015;8(8):1084–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015;385(9986):2477–84.CrossRefPubMedGoogle Scholar
  15. 15.
    Regueiro A, Linke A, Latib A, Ihlemann N, Urena M, Walther T, et al. Association between transcatheter aortic valve replacement and subsequent infective endocarditis and in-hospital death. JAMA. 2016;316(10):1083–92.CrossRefPubMedGoogle Scholar
  16. 16.
    Kurra V, Schoenhagen P, Roselli EE, Kapadia SR, Tuzcu EM, Greenberg R, et al. Prevalence of significant peripheral artery disease in patients evaluated for percutaneous aortic valve insertion: preprocedural assessment with multidetector computed tomography. J Thorac Cardiovasc Surg. 2009;137(5):1258–64.CrossRefPubMedGoogle Scholar
  17. 17.
    Blumenstein J, Kim W-K, Liebetrau C, Gaede L, Kempfert J, Walther T, et al. Challenges of coronary angiography and intervention in patients previously treated by TAVI. Clin Res Cardiol. 2015;104(8):632–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Fusini L, Mirea O, Tamborini G, Muratori M, Gripari P, Cefalù C, et al. Incidence and severity of atherosclerotic cardiovascular artery disease in patients undergoing TAVI. Int J Cardiovasc Imaging. 2015;31(5):975–85.CrossRefPubMedGoogle Scholar
  19. 19.
    Siontis GCM, Praz F, Pilgrim T, Mavridis D, Verma S, Salanti G, et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of severe aortic stenosis: a meta-analysis of randomized trials. Eur Heart J. 2016;37(47):3503–12.CrossRefPubMedGoogle Scholar
  20. 20.
    Thyregod HGH, Steinbrüchel DA, Ihlemann N, Nissen H, Kjeldsen BJ, Petursson P, et al. Transcatheter versus surgical aortic valve replacement in patients with severe aortic valve stenosis: 1-year results from the all-comers NOTION randomized clinical trial. J Am Coll Cardiol. 2015;65(20):2184–94.CrossRefPubMedGoogle Scholar
  21. 21.
    Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609–20.CrossRefPubMedGoogle Scholar
  22. 22.
    Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607.CrossRefPubMedGoogle Scholar
  23. 23.
    Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370(19):1790–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Roy DA, Schaefer U, Guetta V, Hildick-Smith D, Möllmann H, Dumonteil N, et al. Transcatheter aortic valve implantation for pure severe native aortic valve regurgitation. J Am Coll Cardiol. 2013;61(15):1577–84.CrossRefPubMedGoogle Scholar
  25. 25.
    Seiffert M, Bader R, Kappert U, Rastan A, Krapf S, Bleiziffer S, et al. Initial German experience with transapical implantation of a second-generation transcatheter heart valve for the treatment of aortic regurgitation. JACC Cardiovasc Interv. 2014;7(10):1168–74.CrossRefPubMedGoogle Scholar
  26. 26.
    Bagur R, Teefy PJ, Kiaii B, Diamantouros P, Chu MWA. First North American experience with the transfemoral ACURATE-neoTM self-expanding transcatheter aortic bioprosthesis. Catheter Cardiovasc Interv. 2016;90(1):130–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Meredith IT, Walters DL, Dumonteil N, Worthley SG, Tchétché D, Manoharan G, et al. 1-year outcomes with the fully repositionable and retrievable lotus transcatheter aortic replacement valve in 120 high-risk surgical patients with severe aortic stenosis: results of the REPRISE II Study. JACC Cardiovasc Interv. 2016;9(4):376–84.CrossRefPubMedGoogle Scholar
  28. 28.
    Manoharan G, Linke A, Moellmann H, Redwood S, Frerker C, Kovac J, et al. Multicentre clinical study evaluating a novel resheathable annular functioning self-expanding transcatheter aortic valve system: safety and performance results at 30 days with the Portico system. EuroIntervention. 2016;12(6):768–74.CrossRefPubMedGoogle Scholar
  29. 29.
    Lefèvre T, Colombo A, Tchétché D, Latib A, Klugmann S, Fajadet J, et al. Prospective multicenter evaluation of the direct flow medical transcatheter aortic valve system: 12-month outcomes of the evaluation of the direct flow medical percutaneous aortic valve 18F system for the treatment of patients with severe aortic stenosis (DISCOVER) Study. JACC Cardiovasc Interv. 2016;9(1):68–75.CrossRefPubMedGoogle Scholar
  30. 30.
    Petronio AS, Capranzano P, Barbato E, Piazza N, Baumbach A, Haude M, et al. Current status of transcatheter valve therapy in Europe: results from an EAPCI survey. EuroIntervention. 2016;12(7):890–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre Hospitalier Régional Universitaire de LilleLilleFrance
  2. 2.GVM Care and Research, Cardiovascular DepartmentMaria Eleonora HospitalPalermoItaly

Personalised recommendations