Sandeep Nathan, MD, MSc, FACC, FSCAI, Matthew Sherwood, MD, FSCAI, Kendra Grubb, MD, Adam Greenbaum, MD, FSCAI discuss the SCAI Expert Consensus Statement published in JSCAI. The panel provides an insightful overview of the expert consensus, highlighting that alternative access is essential for a small subset of TAVR patients. It emphasizes the most effective techniques, the importance of a collaborative, multidisciplinary approach in patient selection, and the need to recognize institutional resources and operator capabilities for optimal patient outcomes. Additionally, the panel explores how cutting-edge advancements in device technology and imaging are revolutionizing the safety and precision of alternative access TAVR procedures, enhancing both patient care and procedural success. Read the article in JSCAI: https://doi.org/10.1016/j.jscai.2024.102514

	Sandeep Nathan, MD, MSc, FSCAI		Matthew Sherwood, MD, FSCAI
	Kendra J. Grubb, MD		Adam Greenbaum, MD, FSCAI

At the end of this activity, participants should be able to:

• Identify the key techniques and most commonly used routes for alternative access in TAVR.
• Discuss the importance of multidisciplinary collaboration in patient selection and procedural planning for alternative access TAVR.
• Describe the impact of advancements in device technology and imaging on the safety, precision, and outcomes of alternative access TAVR procedures.

Individuals in control of content reported the following relevant financial relationships with ineligible companies during the content development process for this activity. All relevant financial relationships were mitigated before the start of the activity. 

Planner
Alexandra Lansky: Speaker - Shockwave, Emboline; Advisory Board - Shockwave, Emboline; PI - Abbott, Emboline, Innovative Cardiovascular Solutions, Shockwave.

Faculty
Sandeep Nathan: Consulting - Medtronic.
Matthew Sherwood: Advisory Board - Medtronic; Consulting - Medtronic; Site investigator - Abbott.
Kendra J. Grubb: Employed - Medtronic; Speaker - Medtronic; Consultant - Medtronic; Advisory panel - Medtronic.
Adam Greenbaum: Consulting/Honoraria - Edwards Lifesciences, Medtronic, Transmural Systems, Inc.; Equity - Excision Medical, Transmural Systems, Inc.

Reviewer
Robert Bartel: No relevant financial relationships with ineligible companies.

Staff
Amanda Pettyjohn: No relevant financial relationships with ineligible companies.
Kristen Perry: No relevant financial relationships with ineligible companies.
Laura Porter: No relevant financial relationships with ineligible companies.

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