Which of the following surgeries is generally performed via an endovascular approach?

The procedure that is generally performed via an endovascular approach is transcatheter aortic valve replacement (TAVR). This minimally invasive technique allows for the replacement of the aortic valve without the need for open-heart surgery. During TAVR, a catheter is typically inserted through the femoral artery in the groin or through a small incision in the chest wall, providing access to the heart. This method significantly reduces recovery time, hospital stay, and complications compared to traditional surgical techniques, making it a preferred option for high-risk patients with aortic stenosis.

Other surgical options like open heart surgery and coronary artery bypass grafting are invasive approaches that require larger incisions and involve direct access to the heart, which is not consistent with an endovascular methodology. Laparoscopic cholecystectomy, while minimally invasive, is focused on the gallbladder rather than the cardiovascular system and does not utilize the endovascular approach typical of TAVR. Thus, the distinction lies in TAVR’s unique methodology, emphasizing its endovascular nature.