Transcatheter Aortic Valve Implantation – History, Current Guidelines and Implications for the Future

Degenerative aortic stenosis is a disease of the elderly and of growing importance in an ageing population. Due to the impaired life-expectancy of patients with symptomatic aortic stenosis, valve replacement should be performed. Surgical aortic valve replacement is the gold standard treatment; however, median sternotomy and use of extracorporal circulation is a risk for elderly patients with comorbidities. The introduction of transcatheter aortic valve implantation (TAVI) into clinical practice has revolutionized treatment of aortic stenosis in elderly patients. In most patients, TAVI can be performed through the groin vessels using local anaesthesia. Most patients fully recover within a few days. Current debate focuses on whether TAVI should also be used to treat younger patients as data on long-term durability of these valves is insufficient and there is a remaining risk of paravalvular leackage.