Procedural success in transaxillary transcatheter aortic valve implantation according to type of transcatheter heart valve: results from the multicenter TAXI registry

Andreas Schaefer, Oliver D. Bhadra, Lenard Conradi, Dirk Westermann, Caroline Kellner, Ole De Backer, Vilhelmas Bajoras, Lars Sondergaard, Waqas T. Qureshi, Nikolaos Kakouros, Summer Aldrugh, Ignacio Amat-Santos, Tsuyoshi Kaneko, Morgan Harloff, Rui Teles, Tiago Nolasco, Jose Pedro Neves, Miguel Abecasis, Nikos Werner, Michael LauterbachJerzy Sacha, Krzysztof Krawczyk, Carlo Trani, Enrico Romagnoli, Antonio Mangieri, Francesco Condello, Ander Regueiro, Salvatore Brugaletta, Fausto Biancari, Matti Niemelä, Francesco Giannini, Marco Toselli, Rossella Ruggiero, Andrea Buono, Diego Maffeo, Francesco Bruno, Federico Conrotto, Fabrizio D’Ascenzo, Mikko Savontaus, Jouni Pykäri, Alfonso Ielasi, Maurizio Tespili, Michele Cimmino, Michele Albanese, Giuseppe Biondi-Zoccai, Nicola Corcione, Alberto Morello, Arturo Giordano

Research output: Contribution to journalArticlepeer-review


Background: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI. Aims: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV). Methods: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers. Acute procedural, early and 1-month clinical outcomes were adjudicated in accordance with standardized VARC-3 definitions. Results: From 432 patients, 368 patients (85.3%, SE group) received self-expanding (SE) THV and 64 patients (14.8%, BE group) received balloon-expandable (BE) THV. Imaging revealed lower axillary artery diameters in the SE group (max/min diameter in mm: 8.4/6.6 vs 9.4/6.8 mm; p < 0.001/p = 0.04) but a higher proportion of axillary tortuosity in BE group (62/368, 23.6% vs 26/64, 42.6%; p = 0.004) with steeper aorta-left ventricle (LV) inflow (55° vs 51°; p = 0.002) and left ventricular outflow tract (LVOT)-LV inflow angles (40.0° vs 24.5°; 0.002). TAx-TAVI was more often conducted by right sided axillary artery in the BE group (33/368, 9.0% vs 17/64, 26.6%; p < 0.001). Device success was higher in the SE group (317/368, 86.1% vs 44/64, 68.8%, p = 0.0015). In logistic regression analysis, BE THV were a risk factor for vascular complications and axillary stent implantation. Conclusions: Both, SE and BE THV can be safely used in TAx-TAVI. However, SE THV were more often used and were associated with a higher rate of device success. While SE THV were associated with lower rates of vascular complications, BE THV were more often used in cases with challenging anatomical circumstances.

Original languageEnglish
JournalClinical Research in Cardiology
StateAccepted/In press - 2023


  • TAVI
  • TAVR
  • Transaxillary
  • Transcatheter valve therapy
  • Valve disease


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