Axillary artery conduit formation for arterial access during transapical transcatheter aortic valve replacement Journal Article

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Authors: Saxena, P.; Greason, K. L.; Suri, R. M.; Pochettino, A; Holmes, D. R.; Rihal, C. S.; Mathew, V
Article Title: Axillary artery conduit formation for arterial access during transapical transcatheter aortic valve replacement
Abstract: BACKGROUND: 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. METHODS: 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). RESULTS: 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). 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. CONCLUSIONS: Creation of an axillary artery conduit provides a safe arterial access platform for transapical transcatheter aortic valve replacement.
Journal Title: Journal of cardiac surgery
Volume: 29
Issue: 3
ISSN: 1540-8191; 0886-0440
Publisher: Wiley Periodicals, Inc  
Journal Place: United States
Date Published: 2014
Start Page: 308
End Page: 311
Language: eng
DOI/URL:

10.1111/jocs.12326
Notes: LR: 20140425; CI: (c) 2014; JID: 8908809; ppublish