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Transfemoral approach TAVR remains technique of choice and alternative approaches are considered for unfavorable iliofemoral anatomy. Transcarotid approach evidence suggests a lower incidence of postoperative neurovascular and vascular complications. A series of 7 transcarotid approach cases were reviewed. All patients received general anesthesia, femoral access was used for pigtail angiography and trans venous pacing. The neurosurgeon or cardiothoracic surgeon exposed the right common carotid artery and pursestring sutures were placed. The sheath was introduced followed by BAV, and valve delivery system. The TAVR was positioned across the aortic valve and successfully deployed. The carotid puncture site was closed with pursestring sutures and indwell sheath times ranges from 8-30 minutes. Groin access were closed with Angio-seal and Mynx devices. 3 males and 4 females underwent Transcarotid TAVR between July 2015 and November 2016. Mean age was 78.8±7.1 years (Range:71-88). Mean STS% was 8.7±0.8 (Range:4.4-12.3). 6 patients had NYHA Class III and 1 had NYHA Class IV. 4 patients had PVD, 2 had calcified vessels <5mm and 1 had a thrombus in iliofemoral artery. Mean pre-procedure EF was 31±17 % (Range:20-60). Mean pre-procedure gradient across the valve was 40.2 ± 7.5mmHg (Range:30-50) and mean pre-procedure aortic valve area was 0.60 ± 0.25 cm2 (Range:0.27-0.90). Edwards Sapien valve was used for 6 procedures. The mean time for delivery sheath placement and removal was 12.1±2.3 minutes (Range:8.5-14.6). Medtronic CORE EvolutR valve was used for one case with indwell sheath time of 30min. Mean post-procedural EF was 47±16 % (Range:25-65); mean post-procedural gradient across the valve was 12.0±3.2 mmHg(Range:8.7-17.3) and mean post-procedural aortic valve area was 1.58±0.11 cm2 (Range:1.4-1.7). Mean length of stay in ICU was 2.6±2.3 days (Range:1-6), and mean length of hospital stay was 4.4±2.3 (Range:2-8). 2 patients required permanent pacemaker after the procedure. There were no procedure-related complications or TIA, stroke or mortality 30-day follow-up. A multi-disciplinary approach for transcarotid TAVR procedure has shown encouraging initial results. This series demonstrates the viability of a transcarotid approach in patients with access issues. Further investigation into the transcarotid technique may provide additional insights into the risks and benefits of this approach as compared to other transcatheter TAVR approaches.