Journal
JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 17, Pages -Publisher
MDPI
DOI: 10.3390/jcm10173857
Keywords
transapical approach; transapical TAVR; transapical TEVAR; transapical mitral valve repair; transcatheter mitral valve replacement; transapical paravalvular leak repair
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The number of transapical procedures has significantly decreased worldwide with the improvement of devices for the transfemoral approach and the development of other alternative accesses. However, the left ventricular apex has proven to be a safe and valid alternative access for various other structural heart procedures.
Since the advent of TAVR (transcatheter aortic valve replacement), the transapical surgical approach has been affirmed as a safe and effective alternative access for patients with unsuitable peripheral arteries. With the improvement of devices for transfemoral approach and the development of other alternative accesses, the number of transapical procedures has decreased significantly worldwide. The left ventricular apex, however, has proved to be a safe and valid alternative access for various other structural heart procedures such as mitral valve repair, mitral valve-in-valve or valve-in-ring replacement, transcatheter mitral valve replacement (TMVR), transcatheter mitral paravalvular leak repair, and thoracic aorta endovascular repair (TEVAR). We review the literature and our experience of various hybrid transcatheter structural heart procedures using the transapical surgical approach and discuss pros and cons.
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