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Trans-apical TEVAR is discussed as a valid alternative to the conventional trans-arterial retrograde approach for patients with thoracic aortic disease who have inadequate arterial access or limited landing zones.
The endovascular treatment of thoracic aortic disease (TEVAR) is an established treatment option and indications for endoluminal therapy are rapidly expanding (1-3). Advancements in imaging provide careful pre-operative evaluation of the anatomy, making the procedural planning very accurate (4). Nevertheless, despite design improvements in endograft delivery systems, inadequate arterial access (5) and limited landing zones still represent limitations. The apex of the left ventricle (LV) is the “front door” to the arterial vascular system and as such has gained popularity with the introduction of trans-catheter aortic valve implantation (TAVI) (6-9). In this paper we will discuss when and how trans-apical TEVAR (TaTEVAR) is a valid alternative to the conventional trans-arterial retrograde approach.
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Ramponi et al. (2012) conducted a review in Thoracic aortic disease. Trans-apical thoracic endovascular aortic repair (TaTEVAR) was evaluated.
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