ABSTRACT
Aortic stenosis (AS) is the most frequent valvular heart disease in Western countries. A contemporary cohort analysis identified a prevalence constantly increasing with age and reaching up to 9.8" of the population over 80 years, the incidence rate being 4.9 " / year. Two major trans-catheter aortic valve implantation (TAVI) techniques are regularly applied to get access to the aortic valve. The arterial retrograde approach integrates trans-femoral, subclavian/axillary, direct aortic and trans-carotid routes. The trans-apical approach is an antegrade ventricular route. The trans-femoral approach is the most common technique in current practice, representing over 70" of the cases, trans-apical being approximately utilised in 20" of the patients whilst subclavian, direct aortic or less frequently, trans-carotid accesses represent about 10" of the procedures. MRI is also accurate in determining vessel size and tortuosity. Its only limitation is the inability to appreciate calcium burden.
