Suprasternal and Left Axillary Transcatheter Aortic Valve Replacement in Morbidly Obese Patients

Anna Olds; Kyle Eudailey; Tamim Nazif; Torsten Vahl; Omar Khalique; Clifton Lewis; Rebecca Hahn; Martin Leon; Vinayak Bapat; Mustafa Ahmed; Susheel Kodali; Isaac George

doi:10.1016/j.athoracsur.2018.05.095

Suprasternal and Left Axillary Transcatheter Aortic Valve Replacement in Morbidly Obese Patients

Ann Thorac Surg. 2018 Dec;106(6):e325-e327. doi: 10.1016/j.athoracsur.2018.05.095.

Authors

Affiliations

¹ Division of Cardiothoracic Surgery, New York Presbyterian Hospital-College of Physicians and Surgeons of Columbia University, New York, New York.
² Division of Cardiothoracic Surgery, Princeton Baptist Medical Center, Birmingham, Alabama.
³ Division of Cardiology, New York Presbyterian Hospital-College of Physicians and Surgeons of Columbia University, New York, New York.
⁴ Division of Cardiology, Princeton Baptist Medical Center, Birmingham, Alabama.
⁵ Division of Cardiothoracic Surgery, New York Presbyterian Hospital-College of Physicians and Surgeons of Columbia University, New York, New York. Electronic address: [email protected].

PMID: 30009800
DOI: 10.1016/j.athoracsur.2018.05.095

Abstract

In morbidly obese patients who cannot undergo transfemoral, transaortic, or transapical transcatheter aortic valve replacement (TAVR) due to body habitus, suprasternal (SS) and left subclavian/axillary artery (LSCLA) approaches may provide safe TAVR access. Nine morbidly obese patients with a body mass index of 35 or more underwent SS-TAVR (7 patients) or LSCLA-TAVR (2 patients) at two institutions from 2015 to 2017. Mean age was 69.4 ± 7.3 years, and mean body mass index was 50.3 ± 10.6. There were no deaths, valve reinterventions, or reoperations. Three patients required new pacemakers. In morbidly obese patients who are not candidates for the other approaches, SS-TAVR and LSCLA-TAVR allow easier vascular access and prevent the need for thoracotomy or sternotomy.

Publication types

Multicenter Study

MeSH terms

Aged
Aortic Valve Stenosis / complications
Aortic Valve Stenosis / surgery*
Axillary Artery
Humans
Obesity, Morbid / complications
Retrospective Studies
Subclavian Artery
Transcatheter Aortic Valve Replacement / methods*