Background: The transfemoral approach represents the optimal access for TAVI due to its
low invasiveness; however, up to 10–15% of TAVI candidates are considered unsuitable for femoral
access because of significant peripheral vascular disease and need alternative access. Methods:
This is a single-center retrospective observational study including all consecutive adult patients
undergoing transcatheter procedures through a TA approach from March 2015 to April 2024. Results:
213 patients underwent transcatheter aortic or mitral valve implantation through a TA approach
and were enrolled in this study. The mean age of the patients was 79.5 ± 5.7 years, and 54% of
the patients were males. The mean Euroscore II was 7.9 ± 6.4%. One-third of the patients had
previous cardiac surgery. The overall mean survival time was 5.3 ± 0.3 years. Nine (4%) patients
developed infective endocarditis (IE) during the follow-up. Conclusions: The transapical approach
for transcatheter procedures is a safe and effective procedure for patients unsuitable for TF access
with low periprocedural mortality and a low rate of post-procedural complications when performed
by experienced surgeons and cardiologists.