Abstract

Transcatheter Aortic Valve Implantation (TAVI) has been designed to treat elderly patients with severe aortic stenosis considered high-risk surgical candidates. The safety and effectiveness of TAVI have been demonstrated in numerous studies. Retrograde femoral implantation is considered the less invasive approach for TAVI, however TAVI patients are also often affected by severe iliac-femoral arteriopathy, rendering the trans-femoral approach either unemployable or are deemed to carry a high risk of vascular injury. Different arterial alternative access site has been used to implant transcatheter bioprosthesis, the subclavian, the ascending aorta and the carotid artery and more recently. In the present report, we present indication and contraindication to direct aortic approach and we analyzed the key role of computed tomography.

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