[Transcatheter aortic valve implantation: surgeon's view]
Related Experiment Video
Updated: Jun 20, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Sabine Bleiziffer1, Robert Bauernschmitt, Hendrik Ruge
1Klinik für Herz- und Gefässchirurgie, Deutsches Herzzentrum München, München, Germany. bleiziffer@dhm.mhn.de
Background And Purpose:
The technology of catheter- based aortic valve implantation is a new, less invasive therapeutic option for patients with symptomatic high-grade aortic stenosis. The present paper aims to demonstrate that optimal therapy should be provided by a multidisciplinary team consisting of cardiac surgeons, cardiologists and cardioanesthesiologists in a hybrid suite.
Patients And Methods:
From June 2007 to April 2009, 234 patients have been treated by transcatheter aortic valve implantation through different access sites (n = 168 femoral artery, n = 56 left ventricular apex, n = 7 subclavian artery, n = 3 ascending aorta) at the German Heart Center Munich, Germany. An algorithm for the choice of the most appropriate access site for the individual patient was established.
Results:
The 30-day mortality was 11.2% in this high-risk patient cohort. A certain number of periprocedural complications required surgical management. There was a considerable clinical improvement of the patients 6 months after the procedure.
Conclusion:
Integrating the new methods of aortic valve implantation into a cardiac surgery program, all kinds of surgical and interventional treatment options may be offered to the patient with aortic stenosis by one multidisciplinary team. A qualified and safe performance of transcatheter aortic valve implantation and the management of potential complications require the presence of a hybrid suite.
