| Autor: |
Leclercq F; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France., Meunier PA; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France., Gandet T; Department of Anesthesiology and Critical Care Medicine, Montpellier University Hospital, 34295 Montpellier, France., Macia JC; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France., Delseny D; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France., Gaudard P; Department of Anesthesiology and Critical Care Medicine, Montpellier University Hospital, 34295 Montpellier, France., Mourad M; Department of Anesthesiology and Critical Care Medicine, Montpellier University Hospital, 34295 Montpellier, France., Schmutz L; Department of Cardiology, CHU Nimes, Nimes University Hopstal, 30029 Nimes, France., Robert P; Department of Cardiology, CHU Nimes, Nimes University Hopstal, 30029 Nimes, France., Roubille F; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France.; PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier University Hospital, 34090 Montpellier, France., Cayla G; Department of Cardiology, CHU Nimes, Nimes University Hopstal, 30029 Nimes, France., Akodad M; Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France. |
| Abstrakt: |
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. |
