Transaortic Transcatheter Aortic Valve Implantation: Step-by-Step Guide

Transcatheter aortic valve implantation (TAVI) is currently used to treat high-risk and inoperable patients with aortic stenosis. The established routes of access are retrograde transfemoral (TF) and antegrade transapical (TA). Transubclavian and transaortic (TAo) routes have been described. We have performed TAo-TAVI with the Edwards Sapien prosthesis (Edwards Lifesciences, Irvine, CA) with the Ascendra I delivery system. From 2010 we have used the Sapien XT prosthesis with the Ascendra II delivery system. In this article we describe in detail the technical aspects of performing TAo TAVI.