Send to

Choose Destination
JACC Cardiovasc Interv. 2016 Mar 14;9(5):472-80. doi: 10.1016/j.jcin.2015.11.045.

Transcarotid Transcatheter Aortic Valve Replacement: Feasibility and Safety.

Author information

University Hospital Galway, Galway, Ireland.
Department of Cardiology, Hôpital Cardiologique, CHRU de Lille, Lille, France.
Hopital Mondor, Paris, France.
Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France.
Royal Victoria Hospital, Belfast Trust, Queen's University Belfast, Belfast, United Kingdom.
Department of Cardiology, October 6 University, Cairo, Egypt.
Cardiology Department, Al Qassimi Hospital, Dubai, United Arab Emirates.
Department of Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.
Department of Cardiology, Hôpital Cardiologique, CHRU de Lille, Lille, France. Electronic address:



The purpose of this study was to assess the feasibility and safety of transcarotid transcatheter aortic valve replacement (TAVR).


Many candidates for TAVR have challenging vascular anatomy that precludes transfemoral access. Transcarotid arterial access may be an option for such patients.


The French Transcarotid TAVR Registry is a voluntary database that prospectively collected patient demographics, procedural characteristics, and clinical outcomes among patients undergoing transcarotid TAVR. Outcomes are reported according to the updated Valve Academic Research Consortium criteria.


Among 96 patients undergoing transcarotid TAVR at 3 French sites (2009 to 2013), the mean age and Society of Thoracic Surgeons predicted risk of mortality were 79.4 ± 9.2 years and 7.1 ± 4.1%, respectively. Successful carotid artery access was achieved in all patients. The Medtronic CoreValve (Medtronic, Inc., Minneapolis, Minnesota) (n = 89; 92.7%) and Edwards SAPIEN valves (Edwards Lifesciences, Irvine, California) (n = 7; 7.3%) were used. Procedural complications included: valve embolization (3.1%), requirement for a second valve (3.1%), and tamponade (4.2%). There were no major bleeds or major vascular complications related to the access site. There were 3 (3.1%) procedural deaths and 6 (6.3%) deaths at 30 days. The 1-year mortality rate was 16.7%. There were 3 (3.1%) cases of Valve Academic Research Consortium-defined in-hospital stroke (n = 0) or transient ischemic attack (TIA) (n = 3). None of these patients achieved the criteria for stroke and none manifested new ischemic lesions on cerebral computed tomography or magnetic resonance imaging. At 30 days, a further 3 TIAs were observed, giving an overall stroke/TIA rate of 6.3%.


Transcarotid vascular access for TAVR is feasible and is associated with encouraging short- and medium-term clinical outcomes. Prospective studies are required to ascertain if transcarotid TAVR yields equivalent results to other nonfemoral vascular access routes.


aortic stenosis; carotid vascular access; transcatheter aortic valve replacement

Comment in

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center