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Wendt D et al. – This study reflects the authors’ experience with transapical aortic valve implantation in patients presenting with a high surgical risk for conventional aortic valve replacement. Within this patient cohort improved clinical outcome, and lower morbidity and mortality demonstrate a learning curve. Improved results were achieved by patient selection with regard to specific procedure–related risk factors, careful preoperative patient preparation, an optimum interventional and surgical approach, and continuous application of this new procedure.

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