Transapical access and closure devices: rationale and current status

In the past years transcatheter aortic valve implantation became a highly standardized option for the treatment of high-risk patients suffering from severe aortic stenosis. The number of transcatheter aortic valve implantation procedures is increasing exponentially worldwide. In this context the transapical approach should be considered as a safe and reproducible alternative access to the left ventricle with some specific advantages compared with transfemoral, transaortic and transsubclavian approach due to its antegrade nature. To further ease the transapical access first apical closure devices have been developed and entered first clinical trials.