Direct aortic transcatheter aortic valve implantation: a feasible approach for patients with severe peripheral vascular disease.

Aortic stenosis is a prevalent disease with poor prognosis if left untreated. Transcatheter aortic valve implantation (TAVI) is an emerging treatment for patients at high risk for surgery. We describe a patient with no suitable peripheral access due to peripheral vascular disease (PVD) for TAVI. Direct aortic approach via an 18-Fr sheath inserted into the ascending aorta was successfully performed with a 29-mm CoreValve implanted. Direct aortic approach is feasible for TAVI in patients with severe PVD without good peripheral access.