NIH researchers describe less-invasive TAVR access technique
Researchers at the National Institutes of Health yesterday described a new, less-invasive technique for TAVR procedures, the transcaval approach, that could make TAVR more available to the 15% of high-risk patients with too-small or diseased femoral arteries.
In the transcaval approach, surgeons use a small, electrified wire to cross between the abdominal aorta and the inferior vena cava. Then larger openings are made in each vessel; the bleeding from the aorta is immediately pushed into the vena cava by the higher peritoneal pressure in the surrounding area. Developed by surgeons at the National, Heart, Lung and Blood Institute, the procedure can be performed without general anesthesia.
The 100-patient study, also published in the Journal of the American College of Cardiology, was successful in 99 of the patients. The study also showed an acceptable rate of bleeding and vascular complications, particularly in high-risk patients.
“This is a seminal study,” lead author Dr. Adam Greenbaum, of Detroit’s Henry Ford Hospital Center, said in prepared remarks. “It challenged conventional wisdom, which objected to the idea of safe passage between the vena cava and the aorta. More important, it is the first of many non-surgical minimally-invasive tissue-crossing, or so-called transmural catheter procedures developed at NIH that can be applied to diverse fields of medicine.”