Transcatheter aortic valve implantation: new developments and upcoming clinical trials

Transcatheter aortic valve implantation (TAVI) is a relatively new technique that has been introduced to treat inoperable and high-risk patients with severe aortic stenosis. From its early stages it became apparent that TAVI has tremendous potentialities and thus a considerable effort was made to design new prostheses and advance TAVI technology that would make easier and feasible its application in complex anatomies and in patients with multiple comorbidities. In addition, evidence from randomised control trials have emerged demonstrating that it improves prognosis in inoperable patients (PARTNER trial cohort B) and that it can be considered as an attractive alternative to surgery in patients with a high operative risk (PARTNER trial cohort A). These encouraging data have motivated the scientific community to organise further trials, which will examine the performance of new devices and explore the feasibility of TAVI in different groups. In this article we review the literature, present the advances in TAVI technology, cite the evidence from the already published studies and discuss the upcoming clinical trials.