Imaging decision-making for transfemoral or transapical approach of transcatheter aortic valve implantation.

Transcatheter aortic valve implantation has been shown to be a feasible alternative to surgical aortic valve replacement in selected high-risk patients. Although, being less invasive, catheter techniques remain associated with the potential of serious complications. Procedural success and avoidance of such complications critically depends on careful patient selection and comprehensive preprocedural evaluation of vascular access, cardiac and aortic root anatomy. This article reviews the role of currently available imaging modalities for appropriate patient selection and decision between transfemoral and transapical approach.