**5.2 Advantages**

*Vascular Access Surgery - Tips and Tricks*

*George Approach*" [9]

*Transsubclavian artery access.*

**5. Transapical access**

**5.1 Introduction**

**Figure 3.**

ously described transfemoral access

same way as transfemoral approach.

• In some selected cases an 8–10 mm sized Dacron graft can be anastomosed in an end-to-side fashion and then cannulated with the valve deployment sheath

• A fully percutaneuos approach was described in 2012 as the "*Hamburg Sankt* 

• Once the sheath is in place, aortic valve is deployed in same manner as for previ-

• Heparin reversal, sheath removal and control of vascular bleeding are done in

Transapical access (**Figure 4**) is the alternative approach for TAVI in patients in

whom transfemoral or transsubclavian/transaxillary approach is not feasible.

**10**

**Figure 4.**

*Transapical access for TAVI.*

The transapical approach has the following advantages over other approaches:

