Alternative Approaches for TAVI - the Trans-Subclavian Route

Transcatheter Aortic Valve Replacement (TAVI) is one of the methods for an aortic valve replacement, which is made through blood vessels, avoiding the necessity of an open heart surgery. The replacement is performed via several possible access methods: transapical, transfemoral, subclavian, transaortic and transcaval. TAVI is performed in patients with increased risk of an open heart surgery, including patients with: heart failure, coronary artery disease, cerebrovascular and peripherial artery disease, chronic kindey disease and chronic respiratory disfunction.

The PARTNER Trial (Placement of AoRtic TraNscathetER Valves) was the world’s first randomized, controlled study to test the safety and effectiveness of transcatheter heart valves in people with severe aortic stenosis; it was published in 2011 and showed that the procedure was as safe and effective as open-heart surgery, and in those unable to receive surgery, it drastically improved survival.

The following video shows an operative technique for one of the alternative approaches for TAVI - the trans-subclavian route. Video by Mino Mazzitelli.