Key result
Transapical access provides a safe TAVI alternative as new apical closure devices enter clinical trials.
The transapical approach offers a safe, antegrade alternative for TAVI, with novel apical closure devices currently entering clinical trials to facilitate access.
May support transapical TAVI in select patients unsuitable for other access; leaves open the role of new closure devices pending prospective trials.
In the past years transcatheter aortic valve implantation became a highly standardized option for the treatment of high-risk patients suffering from severe aortic stenosis. The number of transcatheter aortic valve implantation procedures is increasing exponentially worldwide. In this context the transapical approach should be considered as a safe and reproducible alternative access to the left ventricle with some specific advantages compared with transfemoral, transaortic and transsubclavian approach due to its antegrade nature. To further ease the transapical access first apical closure devices have been developed and entered first clinical trials.
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Blumenstein et al. (2013) conducted a review in severe aortic stenosis. Transapical access and closure devices vs. transfemoral, transaortic and transsubclavian approach was evaluated. The transapical approach is a safe and reproducible alternative access for transcatheter aortic valve implantation, with new apical closure devices currently entering clinical trials.
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