Transapical approach in transcatheter cardiovascular interventions

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology

Background:

• The left ventricular apex provides optimal access to critical cardiac structures like the aortic and mitral valves.
• While transcatheter aortic valve replacement via the transapical route is declining, it remains vital for patients with poor peripheral vascular access.

Purpose of the Study:

• To review the clinical utility, technical considerations, and potential complications of the transapical approach in diverse transcatheter cardiovascular interventions.
• To highlight the apex as a key access site for mitral valve interventions and other procedures.

Main Methods:

• Review of institutional experience and published literature on transapical transcatheter cardiovascular interventions.
• Discussion of clinical usability, technical tips, and complication management.

Main Results:

• The transapical approach is a versatile option for transcatheter aortic valve replacement, mitral valve repair/replacement, and valve-in-valve procedures.
• It is also utilized for paravalvular leak repair, left ventricular outflow tract pseudoaneurysm repair, and thoracic endovascular aortic repair.

Conclusions:

• The transapical approach remains a valuable strategy for specific patient populations and a range of cardiovascular interventions.
• Understanding its technical nuances and potential complications is crucial for successful application.