A Novel Transcarotid Approach for Implantation of Balloon-Expandable or Self-Expandable Transcatheter Aortic Valves

Transcarotid transcatheter aortic valve replacement (TAVR) is a new alternative in patients with contraindications to other approaches. We report results in 5 patients who underwent TAVR using the common carotid artery approach. Intraprocedural evaluation of the integrity of the circle of Willis was performed by measuring backflow pressure and cerebral oximetry. All patients underwent successful TAVR, without any cerebrovascular or access-related complications. Patient mobilization occurred early postprocedure and 4 of the 5 patients were discharged 3 days after the TAVR procedure. In conclusion, these results suggest that transcarotid access is a safe and feasible secondary TAVR approach.