Femoral access for TAVR: Techniques for prevention and endovascular management of complications

Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as an option for select patients with aortic stenosis who are high risk for conventional aortic valve surgery. The most common site of percutaneous access for TAVR is the common femoral artery (CFA), where the TAVR system is advanced retrograde into the ascending aorta and the stent valve is deployed within the annulus of the stenotic native aortic valve. The transcatheter aortic valve prostheses currently in use require a minimum 18 French (F) delivery sheath for smaller valve sizes. Larger first-generation Sapien 26 mm prostheses (RF3 delivery system) require a 24 F delivery sheath.