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Updated: Mar 23, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Transcatheter Aortic Valve Implantation
S Chris Malaisrie1, Adam Iddriss2,3, James D Flaherty4
1Bluhm Cardiovascular Institute, Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, IL, USA. chris.malaisrie@nm.org.
Abstract:
Severe aortic stenosis (AS) is a life-threatening condition when left untreated. Aortic valve replacement (AVR) is the gold standard treatment for the majority of patients; however, transcatheter aortic valve implantation/replacement (TAVI/TAVR) has emerged as the preferred treatment for high-risk or inoperable patients. The concept of transcatheter heart valves originated in the 1960s and has evolved into the current Edwards Sapien and Medtronic CoreValve platforms available for clinical use. Complications following TAVI, including cerebrovascular events, perivalvular regurgitation, vascular injury, and heart block have decreased with experience and evolving technology, such that ongoing trials studying TAVI in lower risk patients have become tenable. The multidisciplinary team involving the cardiac surgeon and cardiologist plays an essential role in patient selection, procedural conduct, and perioperative care.
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