Catheter-based aortic valve implantation. Techniques

Transcatheter aortic valve implantation -(TAVI) has become a routine procedure for patients with severe aortic stenosis at high risk for conventional surgery. Nowadays five different valve types have achieved a CE-approval and are commercially available in Europe. All are different in various aspects. Of the five possible access routes only transfemoral, transapical and direct aortic approaches are used in significant numbers. A heart team of interventional cardiologists and cardiac surgeons should decide in mutual agreement about the indications and adequate access route in each patient after thorough evalua-tion of high resolution computed tomography (CT) images. The same team of specialists should then perform the implantation in a hybrid operation room especially equipped for TAVI. The development of apical closure devices may draw attention back to the advantages of antegrade transapical access in the future and may possibly enable true percutaneous apical access.