The transcervical access for transcatheter aortic valve replacement.

Alternative accesses for transcatheter aortic valve replacement (TAVR) are needed in a certain number of patients, who present contraindications to the standard transfemoral access. We present the transcervical approach, which allows to access the aortic valve via supra-aortic vessels, namely, the brachiocephalic trunk, carotid artery, or subclavian artery. This approach is interesting because it avoids thoracotomy, which is necessary with some other alternative approaches for TAVR, such as the transaortic or transapical ones. Although some points still need clarification, such as the best anesthesia modality (general or local) or the optimal side for vessel access, data suggest the transcervical access might yield similar periprocedural and 30-day outcomes compared with the transfemoral access. Herein, we describe the surgical technique that was developed in our institution for transcervical access