title: Thoracic aorta stent grafting through transapical access.
abstract: BACKGROUND
  To describe the transapical approach for thoracic endovascular aortic repair (TEVAR).
  
  
  METHODS
  Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The technique is described in detail emphasizing the usefulness of the through-and-through guidewire, rapid pacing, and transesophageal echocardiography guidance.
  
  
  RESULTS
  All patients were technical successfully treated with TEVAR through transapical access. The emergent patient, however, died due to multiorgan failure.
  
  
  CONCLUSIONS
  Our early experience shows that the transapical approach for TEVAR procedures is feasible in experienced hands. The selection of the patient and careful planning based on imaging are of paramount importance and should lead to the most suitable access site tailored to the need of the individual patient.
authors.affiliation: Department of Cardio-Thoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: n.saouti@antoniusziekenhuis.nl.
authors.forename: Nabil
authors.initials: N
authors.lastname: Saouti
authors.affiliation: Department of Radiology, Interventional Radiology, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Jan Albert
authors.initials: JA
authors.lastname: Vos
authors.affiliation: Department of Radiology, Interventional Radiology, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: van de Heuvel
authors.affiliation: Department of Cardio-Thoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: William J
authors.initials: WJ
authors.lastname: Morshuis
authors.affiliation: Department of Cardio-Thoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Robin H
authors.initials: RH
authors.lastname: Heijmen
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents