Transcatheter Aortic Valve Replacement with a Self-expanding Prosthesis

Self-expanding transcatheter valves have evolved significantly into mature therapeutic platforms supported by randomized evidence across the spectrum of surgical risk. The most consistent advantages of self-expanding transcatheter aortic valve replacement remain excellent hemodynamics, especially in small annuli, and the technical flexibility conferred by controlled deployment and recapturability. The principal historical liabilities-pacemaker implantation, paravalvular leak, and coronary reaccess-have improved substantially with new devices and refined implantation technique, although none has been eliminated.