Simplified TAVR Procedure: How Far Is It Possible to Go?
Florence Leclercq
(1)
,
Pierre-Alain Meunier
(1)
,
Thomas Gandet
(2, 1, 3)
,
Jean-Christophe Macia
(1)
,
Delphine Delseny
(1)
,
Philippe Gaudard
(1, 2)
,
Marc Mourad
(1)
,
Laurent Schmutz
(4)
,
Pierre Robert
(1, 4)
,
François Roubille
(2, 1)
,
Guillaume Cayla
(4)
,
Mariama Akodad
(1)
Florence Leclercq
- Fonction : Auteur
- PersonId : 1148426
- ORCID : 0000-0001-5936-5184
Thomas Gandet
- Fonction : Auteur
- PersonId : 1155937
- ORCID : 0000-0002-9352-4895
Philippe Gaudard
- Fonction : Auteur
- PersonId : 19874
- IdHAL : philippe-gaudard
- ORCID : 0000-0003-1192-8704
- IdRef : 069716064
Pierre Robert
- Fonction : Auteur
- PersonId : 1250750
- ORCID : 0000-0001-6664-6849
François Roubille
- Fonction : Auteur
- PersonId : 183497
- IdHAL : francois-roubille
- ORCID : 0000-0002-5288-9687
- IdRef : 11822350X
Guillaume Cayla
- Fonction : Auteur
- PersonId : 1248897
- ORCID : 0000-0002-3958-2568
Résumé
Increasing operators’ experience and improvement of the technique have resulted in a drastic reduction in complications following transcatheter aortic valve replacement (TAVR) in patients with lower surgical risk. In parallel, the procedure was considerably simplified, with a routine default approach including local anesthesia in the catheterization laboratory, percutaneous femoral approach, radial artery as the secondary access, prosthesis implantation without predilatation, left ventricle wire pacing and early discharge. Thus, the “simplified” TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety. The minimalist strategy must not become dogmatic and careful pre-, per- and post-procedural evaluation of patients with well-defined protocols guarantee optimal care following TAVR. This review aims to evaluate the benefits and limits of the simplified TAVR procedure in a current and future vision.
Domaines
Médecine humaine et pathologieFormat du dépôt | Fichier |
---|---|
Type de dépôt | Article dans une revue (article de synthèse) |
Titre |
en
Simplified TAVR Procedure: How Far Is It Possible to Go?
|
Résumé |
en
Increasing operators’ experience and improvement of the technique have resulted in a drastic reduction in complications following transcatheter aortic valve replacement (TAVR) in patients with lower surgical risk. In parallel, the procedure was considerably simplified, with a routine default approach including local anesthesia in the catheterization laboratory, percutaneous femoral approach, radial artery as the secondary access, prosthesis implantation without predilatation, left ventricle wire pacing and early discharge. Thus, the “simplified” TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety. The minimalist strategy must not become dogmatic and careful pre-, per- and post-procedural evaluation of patients with well-defined protocols guarantee optimal care following TAVR. This review aims to evaluate the benefits and limits of the simplified TAVR procedure in a current and future vision.
|
Auteur(s) |
Florence Leclercq
1
, Pierre-Alain Meunier
1
, Thomas Gandet
2, 1, 3
, Jean-Christophe Macia
1
, Delphine Delseny
1
, Philippe Gaudard
1, 2
, Marc Mourad
1
, Laurent Schmutz
4
, Pierre Robert
1, 4
, François Roubille
2, 1
, Guillaume Cayla
4
, Mariama Akodad
1
1
CHRU Montpellier -
Centre Hospitalier Régional Universitaire [Montpellier]
( 258773 )
- 191 avenue du doyen Gaston Giraud 34295 Montpellier
- France
2
PhyMedExp -
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
( 1100749 )
- 371 Avenue du Doyen G. Giraud, CHU Arnaud de Villeneuve, Bâtiment INSERM Crastes de Paulet - 34295 Montpellier Cedex 5
- France
3
LMGC -
Laboratoire de Mécanique et Génie Civil
( 1100646 )
- CC 048 Place Eugène Bataillon, 34095 MONTPELLIER CEDEX 5
- France
4
CHU Nîmes -
Centre Hospitalier Universitaire de Nîmes
( 361498 )
- 4 Rue du Professeur Robert Debré, 30029 Nîmes
- France
|
Langue du document |
Anglais
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Volume |
11
|
Numéro |
10
|
Page/Identifiant |
2793
|
Nom de la revue |
|
Licence |
Paternité
|
Date de publication |
2022-05-16
|
Domaine(s) |
|
Mots-clés |
en
TAVR, Simplification, Tailored approach
|
DOI | 10.3390/jcm11102793 |
Pubmed Id | 35628919 |
PubMed Central | PMC9145302 |
UT key WOS | 000801556900001 |
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