Transcatheter aortic valve implantation: the state of play

Aortic stenosis is the most commonly acquired valvular heart disease in the Western world. Surgical aortic valve replacement is currently the gold-standard treatment for patients with severe symptomatic aortic stenosis. Without surgery, the prognosis is extremely poor, with a 3-year survival rate of less than 30%. Transcatheter aortic valve implantation (TAVI) is a rapidly evolving novel technique that was first introduced in 2002 and is currently available in Europe as an alternative to conventional aortic valve replacement for patients with severe symptomatic aortic stenosis who are deemed to be at too high a risk for open heart surgery. This article describes the TAVI technique and patient selection criteria. We explore how far we have come with advances in TAVI and analyze the short- and medium-term outcome data reported on TAVI so far. We will also look at the potential future role of TAVI and the challenges involved in setting up a TAVI service.