Surgical replacement of aortic valve is the gold standard therapy for severe aortic valve stenosis. Transcatheter Aortic Valve Implantation (TAVI) is less invasive and becomes an alternative therapy reserved for patients with high operative risk. TAVI can be performed via transfemoral, transapical or transaortic approach. Patients with diseased or difficult femoral/iliac vascular access, poor left ventricular function and significant respiratory disease are not suitable for transfemoral or transapical approach. In this scenario, direct transaortic approach of TAVI is a feasible option. This case report presents a case of a 76-year-old man with symptomatic severe aortic valve stenosis who underwent general anaesthesia and was successfully treated by direct transaortic TAVI using Edwards Sapien XT aortic bioprosthesis.
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