Transcatheter aortic valve implantation - what the general physician needs to know

With an increasingly elderly population, the incidence of aortic stenosis (AS) is rising. While surgical aortic valve replacement remains the gold standard treatment for patients with severe symptomatic AS, transcatheter aortic valve implantation (TAVI) has emerged as the treatment of choice for patients who are inoperable or high surgical risk. TAVI has been shown to be associated with a clear mortality benefit when compared with medical therapy and to be at least as good as surgical aortic valve replacement in this patient group. The last few years have seen rapid development in this revolutionary technology in conjunction with increasing centre and operator experience, and indications for the procedure are swiftly expanding. In this review, we summarise the current evidence base and discuss factors that need to be considered by the general physician when contemplating TAVI as a treatment option, including practical aspects, emerging indications and future directions.