Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR): How It Started, How It's Going, and Where It's Going

Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR) has come a long way since the first-in-human implant by Prof Cribier & colleagues in 2002. Initially a consideration for inoperable/high-surgical-risk patients, TAVI is now indicated in patients with severe tricuspid aortic stenosis and suitable anatomy aged 70 or higher. This has been made possible due to improvements in preprocedural planning, performance upgrades to and evolution of transcatheter heart valve (THV) systems and increasing operator experience. Younger age at index implantation, complexities of redo TAVI planning and methods to improve THV durability are the next frontiers. This review summarizes these advancements while emphasizing preprocedural planning, current guidelines, and individualized device selection, with a brief note on polymeric heart valves-developed to overcome the disadvantageous bioprosthetic dysfunction seen with current THVs.