Ipsilateral trans-axillary aortic valve replacement in a patient with
ilio-femoral and coronary artery bypass surgery, permanent pacemaker and
subclavian stent
Abstract
Transcatheter aortic valve replacement (TAVR) has become the procedure
of choice for patients deemed high-risk or inoperable for surgical
aortic valve replacement. For patients with inadequate iliofemoral
access, the risk of vascular injury is extremely high and alternative
techniques have been utilized and include the transapical, transaortic
and transsubclavian or transaxillary (TAx) routes. Alternative
approaches often require open surgical exposure under general
anesthesia. Herein, we describe a unique TAx TAVR with a
balloon-expandable Edwards SAPIEN 3 device in a 77 year-old male patient
with the history of coronary artery and ilio-femoral bypass surgery,
permanent pacemaker implantation at the left pectoral fossa and left
subclavian artery stent.