title: Transcatheter aortic valve implantation transapical: step by step.
abstract: Transcatheter aortic valve implantation (T-AVI) has been introduced into clinical practice to treat high-risk elderly patients with aortic stenosis. T-AVI can be performed by using a retrograde transfemoral (TF), transsubclavian, transaortic, and/or antegrade transapical (TA) approach. For TA-AVI, CE mark approval was granted in 2008 for the Edwards SAPIEN (Edwards Lifesciences, Irvine, CA) prosthesis with the Ascendra delivery system and in 2010 for the second-generation Edwards SAPIEN XT prosthesis and the Ascendra II delivery system, with 23-mm and 26-mm valves. In 2011, CE mark approval has been granted for TA-AVI by using the SAPIEN XT 29-mm prosthesis. Several other devices from different companies (Jenavalve, Jena Valve Inc, Munich, Germany; Embracer, Medtronic Inc, Guilford, CT; Accurate, Symetis Inc, Geneva, Switzerland) have passed "first in man trials" successfully and are being evaluated within multicenter pivotal studies. In this article we will focus on specific aspects of the TA technique for AVI.
authors.affiliation: Department of Cardiac Surgery, Kerckhoff HeartCenter, Bad Nauheim, Germany. t.walther@kerckhoff-klinik.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.forename: Arnaud
authors.initials: A
authors.lastname: van Linden
authors.forename: Jörg
authors.initials: J
authors.lastname: Kempfert
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002404:Catheterization; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D018579:Patient Selection; D011474:Prosthesis Design; D015641:Radiography, Interventional; D018570:Risk Assessment; D016896:Treatment Outcome