Simplified TAVR Procedure: How Far Is It Possible to Go?

Florence Leclercq (1) , Pierre-Alain Meunier (1) , Thomas Gandet (2, 1) , Jean-Christophe Macia (1) , Delphine Delseny (1) , Philippe Gaudard (1, 2) , Marc Mourad (1) , Laurent Schmutz (3) , Pierre Robert (1, 3) , François Roubille (2, 1) , Guillaume Cayla (3) , Mariama Akodad (1)

1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
3 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes

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.

Mots clés: TAVR; Simplification; Tailored approach

Domaines: Médecine humaine et pathologie

Florence Leclercq, Pierre-Alain Meunier, Thomas Gandet, Jean-Christophe Macia, Delphine Delseny, et al.. Simplified TAVR Procedure: How Far Is It Possible to Go?. Journal of Clinical Medicine, 2022, 11 (10), pp.2793. ⟨10.3390/jcm11102793⟩. ⟨hal-03680785v2⟩