Transcatheter aortic valve implantation in patients at intermediate surgical risk

Transcatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic stenosis (AS). Initially tested in unoperable or high surgical risk patients, the safety and efficacy of TAVI has progressively improved, with increasing operators' experience and continuous technical refinements of the devices and of the delivery systems. Hence, the extension of clinical indications for TAVI to the intermediate-risk population has been attracting cardiologists in recent years. This idea was supported by the results of recent studies suggesting that transfemoral TAVI might be associated with a survival benefit in both high- and intermediate-risk patients with severe AS. Therefore, the aim of this review is to summarize the currently available evidence from multiple observational studies, substudies from large country registries, mached group comparisons, a substudy of randomized studies, and randomized trials, as well as in recent meta-analyses on the use of TAVI in patient at intermediate-risk for surgery.