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Updated: Jun 20, 2026
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
[Experience and learning curve with transapical aortic valve implantation]
Daniel Wendt1, Holger Eggebrecht, Philipp Kahlert
1Klinik für Thorax- und Kardiovaskuläre Chirurgie, Westdeutsches Herzzentrum Essen, Universitätsklinikum der Universität Duisburg-Essen, Essen, Germany.
Herz
|August 28, 2009
Summary
Transapical transcatheter aortic valve implantation (TAVI) shows a learning curve in high-risk patients. Improved outcomes, including reduced procedure time and mortality, demonstrate proficiency gains with experience.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Technology Innovation
Background:
- Transapical transcatheter aortic valve implantation (TAVI) is an alternative for high-risk patients with severe aortic valve stenosis.
- Conventional aortic valve replacement poses significant risks for this patient population.
Purpose of the Study:
- To evaluate the learning curve associated with transapical TAVI.
- To assess the impact of experience on procedural outcomes and patient safety.
Main Methods:
- A cohort of 40 high-risk patients underwent transapical TAVI between October 2007 and May 2009.
- Patients were divided into two groups (initial 20 vs. subsequent 20) to analyze the learning curve.
- Key procedural metrics and clinical outcomes were compared between the groups.
Main Results:
- Procedural success rate was high at 97.5% with no prosthesis migration or coronary obstruction.
- Significant reductions in procedural time, fluoroscopy time, and contrast media volume were observed in the second group.
- Observed 30-day mortality decreased from 25% to 10% between the initial and later patient cohorts.
Conclusions:
- The study demonstrates a clear learning curve for transapical TAVI.
- Improved patient selection, preparation, and procedural technique contribute to better clinical outcomes.
- Experience with transapical TAVI leads to reduced morbidity and mortality in high-risk patients.
