Transapical approach in transcatheter cardiovascular interventions.

The left ventricular apex has excellent accessibility to the aortic valve, mitral valve, left ventricular outflow tract and thoracic aorta. Although the number of transapical approach in transcatheter aortic valve replacement has been decreasing in recent years, it is still a useful option for patients with very poor peripheral vascular access. The apex has been chosen as a primary access site for many devices of transcatheter mitral valve repair/replacement and mitral valve-in-valve procedures. Additionally, the transapical approach has been used for other transcatheter cardiovascular interventions such as paravalvular leak repair after mitral or aortic valve replacement, pseudoaneurysm repair of the left ventricular outflow tract, and thoracic endovascular aortic repair. Herein, I review our own experience and articles of the transapical transcatheter cardiovascular interventions and discuss about clinical usability, technical tips and complications of the transapical approach in various transcatheter cardiovascular interventions.