Not All Alternatives Are Created Equal.

We thank Dr Useini 1 Useini D. Appropriate alternative is better than preferred alternative. Ann Thorac Surg. 2022; 113: 1750 Abstract Full Text Full Text PDF Scopus (1) Google Scholar for his thoughtful comments regarding our study. 2 Kindzelski B. Mick S.L. Krishnaswamy A. et al. Evolution of alternative-access transcatheter aortic valve replacement. Ann Thorac Surg. 2021; 112: 1877-1885 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar In response, we provide the following clarifications that support transaxillary transcatheter aortic valve replacement (TAVR) as not just a preferred approach to transthoracic approaches but as an appropriate approach. Appropriate Alternative Is Better Than Preferred AlternativeThe Annals of Thoracic SurgeryVol. 113Issue 5PreviewI read with great interest the article by Kindzelski and colleagues1 in which the authors aimed to explain why transaxillary transcatheter aortic valve replacement (Tax-TAVR) has evolved as the preferred alternative at the Cleveland Clinic. I appreciate the authors’ great experience with different TAVR approaches achieving excellent results. However I have some concerns because the authors concluded superior operative outcomes after Tax-TAVR compared with transthoracic TAVR. Full-Text PDF