[Transcatheter aortic valve implantation (TAVI): Current perspectives]

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter aortic valve implantation (TAVI) is a primary treatment for elderly patients with severe aortic stenosis at high surgical risk.
• Over 10,000 TAVI procedures were performed in Germany in 2014.
• TAVI has demonstrated a mortality benefit over conservative treatment in inoperable patients and is non-inferior to surgical aortic valve replacement in high-risk individuals.

Purpose of the Study:

• To review the evolution and current status of Transcatheter Aortic Valve Implantation (TAVI).
• To highlight the advancements in TAVI technology and procedural techniques.
• To emphasize the importance of interdisciplinary decision-making for optimal patient outcomes.

Main Methods:

• Review of recent studies and procedural data on TAVI.
• Analysis of TAVI outcomes compared to conservative treatment and surgical aortic valve replacement.
• Assessment of technological and experience-driven improvements in TAVI.

Main Results:

• TAVI offers a mortality benefit compared to conservative care and is non-inferior to surgical replacement in high-risk patients.
• Significant improvements in imaging, valve technology, and operator experience have reduced complication rates.
• Emerging data suggests TAVI may be superior to surgical valve replacement in intermediate-risk patients.

Conclusions:

• TAVI is a rapidly advancing treatment option for severe aortic stenosis, particularly in elderly and high-risk populations.
• Minimizing procedure-specific complications remains crucial for optimal TAVI outcomes.
• Interdisciplinary heart team decisions are essential for tailoring TAVI therapy to individual patients.
• Further randomized trials are needed to explore expanding TAVI indications to lower-risk patients.