The “hidden experiment”: percutaneous vs. surgical cut-down for transfemoral transcatheter aortic valve implantation

Exactly 10 years ago, the Rotterdam group reported on the first true percutaneous implantation of the 18 Fr CoreValve Revalving System (Medtronic, Minneapolis, MN, USA) by the combined use of ultrasound-guided vascular access, Prostar® XL (Abbott Vascular, Santa Clara, CA, USA), and TandemHeart™ (Cardiac Assist Inc., Pittsburgh, PA, USA) support1. Possibly overlooked, this transformative moment was the embodiment of the much-heralded movement of TAVI towards a true “PCI-like” intervention. As a result of the downsizing of delivery catheters and the implementation of best practice guidelines, a percutaneous transfemoral approach is now used in more than 90% of patients undergoing TAVI at most ...