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Related Experiment Video

Updated: Jun 28, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

The transapical approach for aortic valve implantation.

Andreas Zierer1, Gerhard Wimmer-Greinecker, Sven Martens

  • 1Division of Cardiothoracic Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt, Main, Germany.

The Journal of Thoracic and Cardiovascular Surgery
|October 29, 2008
PubMed
Summary

The transapical approach for aortic valve implantation offers an alternative for high-risk patients. This method allows accurate antegrade valve placement, with initial results showing promise for severe aortic stenosis treatment.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe aortic stenosis poses significant risks, especially for high-risk patients.
  • Transfemoral retrograde percutaneous aortic valve implantation is limited by peripheral vascular disease and device size.
  • An alternative delivery method is needed for complex aortic stenosis cases.

Purpose of the Study:

  • To evaluate the feasibility and initial outcomes of the transapical approach for aortic valve implantation.
  • To assess the safety and efficacy of antegrade catheter-based aortic valve delivery.
  • To provide an alternative to transfemoral delivery in high-risk patients.

Main Methods:

  • 26 high-risk patients (mean age 84.3 years) with severe aortic stenosis underwent transapical aortic valve implantation.

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Related Experiment Videos

Last Updated: Jun 28, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

  • Pericardial valves (23-mm and 26-mm) were delivered via a limited anterolateral thoracotomy to the cardiac apex.
  • Fluoroscopy and transesophageal echocardiography guided valve deployment, with extracorporeal support or rapid pacing used for unloading.

    • Main Results:

    • Successful deployment of all aortic valves was achieved.
    • Echocardiography demonstrated good hemodynamic function with minor paravalvular leakages and a mean transaortic gradient of 6 +/- 2 mm Hg.
    • Thirty-day mortality was 15% (4 patients), with complications including ventricular perforation, aortic root dissection, and conversion to open surgery.

    Conclusions:

    • The transapical approach for aortic valve implantation shows encouraging initial results in high-risk patients.
    • This antegrade technique provides a viable alternative for patients unsuitable for transfemoral delivery.
    • Further long-term studies and randomized trials are necessary to fully establish the procedure's value.