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Updated: May 8, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Transaortic access is the key to success.
Vinayak N Bapat1, Giuseppe Bruschi
1Department of Cardiothoracic Surgery, Guy's and St. Thomas' Hospital, London, United Kingdom.
Summary
The transaortic (TAo) approach for transcatheter aortic valve implantation (TAVI) offers a familiar and less invasive surgical option. This method may reduce complications and learning curves for surgeons using established TAVI devices.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Transcatheter aortic valve implantation (TAVI) is a standard procedure for aortic valve replacement.
- Transfemoral and transapical approaches are common, but alternative methods are emerging to improve outcomes.
Purpose of the Study:
- To discuss the advantages, indications, contraindications, surgical technique, and results of the transaortic (TAo) approach for TAVI.
- To highlight the versatility and less invasive nature of the TAo approach.
Main Methods:
- The TAo approach involves accessing the ascending aorta via sternotomy or thoracotomy.
- This approach is compatible with Edwards SAPIEN Valve and Medtronic CoreValve devices.
- Surgical technique, patient selection, and outcomes are detailed.
Main Results:
- The TAo approach leverages surgeons' existing expertise, potentially reducing the learning curve.
- It may lead to fewer access site-related complications compared to other TAVI methods.
- Ongoing registries and trials are expected to provide robust data on TAo approach efficacy.
Conclusions:
- The transaortic approach is a viable and potentially advantageous alternative for TAVI.
- Further data from registries like ROUTE will solidify the benefits of this less invasive TAVI method.
