This study showed the feasibility and safety of using the EED system in TAVR procedures. The EED system did not prevent the occurrence of cerebral microemboli during TAVR or new transient ischemic lesions as evaluated by DW-MRI, but it was associated with a reduction in lesion volume. Further studies are warranted to determine the efficacy of using the EED system during TAVR procedures.

Our study shows no significant differences in the rate of major complications after utilization of a collagen-based VCD for femoral artery access site closure in patients with severe lower limb PAD compared to those without; however, complications in the PAD group tended to be more severe, with the need for surgical repair.

Acquired aortic stenosis (AS) resulting from calcification of the aortic valve is the most frequent acquired valve disease in Europe. Due to the increasing average life expectancy the population in the western industrial world is aging, and consequently the prevalence of AS requiring aortic valve replacement (AVR), particularly in older patients, is continuously increasing. However, the risk of conventional AVR with the use of sternotomy, cardiopulmonary bypass, and cardioplegic cardiac arrest is obviously higher in the elderly patient, in whom significant comorbidities may additionally pre-exist. Moreover, there is recent evidence that 30-40% of the patients with severe and/or symptomatic AS in Europe remain untreated and nearly half of them are considered "too sick" for surgery. Thus, there seems to be a role for less invasive treatment options, like transcatheter aortic valve implantation (TAVI) techniques, addressing an unmet patient and medical need. Today, an increasing number of different transcatheter heart valve devices for aortic valve implantation is coming up; however, so far only for two systems there is broad clinical experience with human implantations. The following article is aimed to describe the current transcatheter aortic valve implantation technique with full details of the procedural steps, both via the transfemoral and via the transapical access using the balloon-expandable SAPIEN transcatheter aortic heart valve device.

Calcified aortic stenosis is the predominant valve disease. Patients affected are most commonly elderly people, who often show associated comorbidities like reduced left ventricular function, impaired renal function, and pulmonary hypertension. The risk of open-heart surgery is elevated. Balloon aortic valvuloplasty enables a reduction of symptoms, an increase in physical performance, and, therefore, an improved quality of life. However, a reduction in mortality cannot be reached with this method. New techniques and improved equipment induced a "revival" of balloon aortic valvuloplasty, which has been introduced almost 20 years ago. In addition, brachytherapy after balloon valvuloplasty has recently been investigated and represents an interesting approach to reduce early restenosis. The technical improvement of balloon valvuloplasty is the percutaneous heart valve, which is under present clinical investigation. The antegrade/transseptal and retrograde approaches are used, as is the transapical access to the left ventricle. Even if long-term results are not yet available and the procedures still require technical improvement, especially minimization of catheter size, percutaneous valve replacement is a new chapter in the treatment of the calcified aortic stenosis.