The evolution of transapical aortic valve implantation and new perspectives

Transapical aortic valve implantation (TA-AVI) is a truly minimally invasive technique allowing for off-pump aortic valve implantation in selected high-risk patients. Potential advantages are the avoidance of cardiopulmonary bypass, cross-clamping and sternotomy. Compared to transfemoral aortic valve implantation the current strengths of the transapical approach are the avoidance of the femoral arteries as well as a very low stroke risk due to minimal manipulations in the aortic arch. TA-AVI has evolved to a routine procedure in selected specialized centers providing a safe and reproducible treatment option for high-risk elderly patients suffering from severe symptomatic aortic stenosis.