{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:52:16Z","timestamp":1783637536892,"version":"3.55.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The axillary artery is an alternative access route for transcatheter aortic-valve implantation (TAVI) in patients who have unfavourable femoral arteries as well as comorbidities which preclude surgery. Transaxillary TAVI (TAx-TAVI), with a complete non-transfemoral approach, is a feasible and safe alternative even if complications like vascular closure device failure with bleeding occurs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe here a simplified non-transfemoral TAx-TAVI approach in a 71-year-old patient with pulmonary oedema due to severe symptomatic aortic stenosis with a prohibitively high surgical risk (Society of Thoracic Surgeons Mortality 11.9%) and extensive peripheral artery disease that rendered the femoral arteries unsuitable for access. Importantly, this strategy also allows for successful management of bleeding events, particularly those associated with vascular closure device failure, by the use of a new covered stent device. The patient was discharged on Day 6 after admission in stable conditions. In short-term follow-up (30 days), he is asymptomatic with normal left-ventricular function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The TAx-TAVI is a promising alternative to transfemoral TAVI approach. Patient safety, even during bleeding complications, can be guaranteed with appropriate preparation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac280","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T09:46:56Z","timestamp":1657014416000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful management of a bleeding complication during transaxillary transcatheter aortic-valve implantation: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9997-9201","authenticated-orcid":false,"given":"Philipp","family":"Lauten","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Center, Zentralklinik Bad Berka , Robert-Koch-Allee 9 , 99437 Bad Berka, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El-Garhy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Zentralklinik Bad Berka , Robert-Koch-Allee 9 , 99437 Bad Berka, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Al-Jassem","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, Heart Center, Zentralklinik Bad Berka , 99437 Bad Berka , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Lapp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Zentralklinik Bad Berka , Robert-Koch-Allee 9 , 99437 Bad Berka, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"2022072008004182700_ytac280-B1","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1056\/NEJMc1408396","article-title":"Transcatheter aortic-valve replacement with a self-expanding prosthesis","volume":"371","author":"Adams","year":"2014","journal-title":"N Engl J Med"},{"key":"2022072008004182700_ytac280-B2","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery","volume":"363","author":"Leon","year":"2010","journal-title":"N Engl J Med"},{"key":"2022072008004182700_ytac280-B3","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N Engl J Med"},{"key":"2022072008004182700_ytac280-B4","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"Surgical or transcatheter aortic-valve replacement in intermediate-risk patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N Engl J Med"},{"key":"2022072008004182700_ytac280-B5","doi-asserted-by":"crossref","first-page":"AB40","DOI":"10.4244\/EIJ-D-18-00552","article-title":"Current state of alternative access for transcatheter aortic valve implantation","volume":"14","author":"Lanz","year":"2018","journal-title":"EuroIntervention"},{"key":"2022072008004182700_ytac280-B6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jcin.2018.10.041","article-title":"Completely percutaneous transaxillary aortic valve implantation under local anesthesia: a minimalist alternative access approach","volume":"12","author":"Ooms","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2022072008004182700_ytac280-B7","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ijcard.2017.01.010","article-title":"Safety and efficacy of the percutaneous transaxillary access for transcatheter aortic valve implantation using various transcatheter heart valves in 100 consecutive patients","volume":"232","author":"Schafer","year":"2017","journal-title":"Int J Cardiol"},{"key":"2022072008004182700_ytac280-B8","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1093\/eurheartj\/ehz275","article-title":"Transcatheter aortic valve implantation vs. Surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis","volume":"40","author":"Siontis","year":"2019","journal-title":"Eur Heart J"},{"key":"2022072008004182700_ytac280-B9","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.carrev.2020.11.025","article-title":"Simplified trans-axillary aortic valve replacement under local anesthesia\u2014a single-center early experience","volume":"23","author":"Ooms","year":"2021","journal-title":"Cardiovasc Revasc Med"},{"key":"2022072008004182700_ytac280-B10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1161\/CIRCULATIONAHA.121.057856","article-title":"Comparison of a pure plug-based versus a primary suture-based vascular closure device strategy for transfemoral transcatheter aortic valve replacement: the CHOICE-CLOSURE randomized clinical trial","volume":"145","author":"Abdel-Wahab","year":"2022","journal-title":"Circulation"}],"container-title":["European Heart Journal - Case 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