TY  - BOOK
AU  - Akbari, Cameron M
AU  - Barbash, Israel M
AU  - Beavers, Frederick P
AU  - Ben-Dor, Itsik
AU  - Dvir, Danny
AU  - Momin, Takki
AU  - O'Donnell, Sean
AU  - Okubagzi, Petros
AU  - Pichard, Augusto D
AU  - Ricotta, John J
AU  - Satler, Lowell F
AU  - Waksman, Ron
TI  - Graft-free surgical retroperitoneal vascular access as bail-out technique for failed percutaneous approach to transcatheter aortic valve replacement
SN  - 1878-0938
PY  - 2013///
KW  - *Aortic Valve Stenosis/th [Therapy]
KW  - *Cardiac Catheterization
KW  - *Femoral Artery
KW  - *Heart Valve Prosthesis Implantation/mt [Methods]
KW  - *Iliac Artery
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Cardiac Catheterization/ae [Adverse Effects]
KW  - Chi-Square Distribution
KW  - Female
KW  - Femoral Artery/ra [Radiography]
KW  - Heart Valve Prosthesis Implantation/ae [Adverse Effects]
KW  - Humans
KW  - Iliac Artery/ra [Radiography]
KW  - Male
KW  - Punctures
KW  - Radiography, Interventional
KW  - Retroperitoneal Space/su [Surgery]
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - Time Factors
KW  - Treatment Failure
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital
KW  - Surgery/Vascular Surgery
KW  - Comparative Study
KW  - Journal Article
KW  - Video-Audio Media
N1  - Available in print through MWHC library: 2002 - present
N2  - BACKGROUND: Surgical retroperitoneal access to the iliac artery may provide an alternative route for transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis and prohibitively small common femoral arteries; CONCLUSIONS: Surgical retroperitoneal access is a reasonable alternative for transcatheter aortic valve replacement in high-risk patients with aortic stenosis who have poor percutaneous access options due to peripheral vascular disease. Copyright  2013. Published by Elsevier Inc; METHODS: Consecutive patients undergoing TAVR via the femoral approach were divided into two groups; standard percutaneous access (n=103) and surgical retroperitoneal access (n=15) for patients in whom dilators could not be advanced without resistance. For retroperitoneal access, proximal groin vessels were exposed surgically and direct puncture was performed. The sheath was tunneled from the level of the initial inguinal puncture site in order to achieve coaxial entry of the sheath into the vessel; RESULTS: Baseline characteristics were similar in both groups. Procedural characteristics were insignificantly different between groups; although, procedure time was longer (34 min), while fluoroscopy time and contrast utilization were lower in the retroperitoneal access group. There was no outcome difference between groups
UR  - http://dx.doi.org/10.1016/j.carrev.2012.09.005
ER  -