Conclusion
According to our data, the TA and SC approaches were associated with
almost similar long-term survival. Based on these findings, the key
message of this study is that SC and TA are established, feasible and
comparatively safe alternative strategies to the default retrograde
femoral access for TAVI. However,
in more recent years, there has been an increase in the use of the
subclavian and axillary route, including percutaneous approaches
performed under local anaesthetic, and a corresponding decline in TA
access. As with any operative technique, the choice to select a specific
approach is determined by different combinations of patients’
comorbidity, vascular characteristics, transcatheter aortic valve
prosthesis, availability of new performing devices on the market, and
skill, mastery, expertise, and experience of the entire Heart Team, who
remains the key factor to lead to the best choice tailored for each
single patient.