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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">97</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:B5033382-9D21-53CE-B630-B4E3A1146D51</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Bulgarian Cardiology</journal-title>
        <abbrev-journal-title xml:lang="en">Bulgarian Cardiology</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">1310-7488</issn>
      <issn pub-type="epub">2683-1015</issn>
      <publisher>
        <publisher-name>Bulgarian Society of Cardiology</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/bgcardio.28.e83660</article-id>
      <article-id pub-id-type="publisher-id">83660</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Interventional Cardiology (интервенционална кардиология)</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Transcatheter aortic valve implantation via transaortic surgical access</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Popova</surname>
            <given-names>A.</given-names>
          </name>
          <email xlink:type="simple">anna_danielova@hotmail.com</email>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Trendafilova</surname>
            <given-names>D.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Jorgova</surname>
            <given-names>J.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Petkov</surname>
            <given-names>D.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Abedinov</surname>
            <given-names>F.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Hristova</surname>
            <given-names>T.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Ivanov</surname>
            <given-names>S.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">"Sveta Ekaterina" University Hospital for Active Treatment, Sofia, Bulgaria</addr-line>
        <institution>"Sveta Ekaterina" University Hospital for Active Treatment</institution>
        <addr-line content-type="city">Sofia</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: A. Popova (<email xlink:type="simple">anna_danielova@hotmail.com</email>).</p>
        </fn>
        <fn fn-type="edited-by">
          <p>Academic editor: Plamen Panayotov</p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>20</day>
        <month>06</month>
        <year>2022</year>
      </pub-date>
      <volume>28</volume>
      <issue>2</issue>
      <fpage>123</fpage>
      <lpage>129</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/53A3CE6B-2EC8-5B54-BC0D-1E008A0AF74B">53A3CE6B-2EC8-5B54-BC0D-1E008A0AF74B</uri>
      <history>
        <date date-type="received">
          <day>21</day>
          <month>03</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>05</day>
          <month>04</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>A. Popova, D. Trendafilova, J. Jorgova, D. Petkov, F. Abedinov, T. Hristova, S. Ivanov</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p>We report a case of an 80-years–old patient with a severe, symptomatic aortic valve stenosis and history of ischemic heart disease, previously treated by coronary artery bypass graft surgery. The patient was contraindicated for conventional surgical aortic valve replacement (SAVR) due to advanced age and underlying comorbidity, therefore transcatheter aortic valve implantation (TAVI) has been offered. The access options for the procedure were restricted by the underlying generalized atherosclerosis process causing peripheral vessel disease. We have chosen transaortic access for the patient which in that case was the only possible option. The transaortic valve implantation was successful with satisfactory hemodynamic results, improvement in functional class heart failure of the patient and preserving the function and anatomy of the coronary artery bypass graft. This case report demonstrates that the lack of favorable transfemoral access for TAVI should not be a limitation by itself for the procedure, rather than be stimulus for searching and using new and alternative access for it.</p>
      </abstract>
    </article-meta>
  </front>
</article>
