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Updated: Mar 3, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Is TAVR Ready for the Global Aging Population?
Travis Bergmann1, Partho P Sengupta1, Jagat Narula1
1Cardiac Ultrasound Research and Core Lab, Department of Medicine, Mount Sinai's Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA.
Insights
Transcatheter aortic valve replacement (TAVR) offers a minimally invasive option for aortic stenosis. This review explores adapting TAVR for low-resource regions through telemedicine and simplified approaches.
Area of Science:
- Cardiology
- Medical Technology
- Global Health
Background:
- Chronic diseases, including valvular heart disease like aortic stenosis, are a growing global health concern.
- Transcatheter aortic valve replacement (TAVR) has emerged as a less invasive alternative to surgical aortic valve replacement.
- Current TAVR procedures are complex, often requiring specialized teams and infrastructure.
Purpose of the Study:
- To assess the feasibility and adaptability of TAVR in low-resource settings.
- To identify strategies for overcoming barriers to TAVR implementation in underserved regions.
- To explore innovative approaches for global TAVR accessibility.
Main Methods:
- This is a review article, synthesizing existing literature and proposing future strategies.
- Analysis of current TAVR requirements and resource utilization.
- Exploration of potential adaptations for resource-limited environments.
Main Results:
- TAVR, while revolutionary, faces significant resource and expertise challenges in low-resource regions.
- Telemedicine networks, simplified valve designs, and reduced specialist requirements are proposed solutions.
- These adaptations could facilitate wider global adoption of TAVR.
Conclusions:
- Adapting TAVR for low-resource settings is crucial for addressing the global burden of aortic stenosis.
- Innovative strategies focusing on telemedicine and resource optimization are key to expanding TAVR access.
- Successful implementation in low-resource regions has the potential to significantly impact global cardiovascular care.
Abstract:
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR). This review examines whether TAVR can be applicable in low-resource regions across the world. Although revolutionary, TAVR is currently complex and requires a "Heart Team" approach for optimized patient care. We propose the emergence of telemedicine networks, newer valve designs that allow implementation of minimal approaches, and the use of minimal numbers of specialists for adapting TAVR to settings where surgical backup is not available. With efforts to reduce resource utilization, these alternate strategies have the potential to affect implementation of TAVR globally.
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