Pros and cons of transcatheter aortic valve implantation (TAVI)

Juan A. Terré, Isaac George, Craig R. Smith

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Transcatheter aortic valve implantation (TAVI) or replacement (TAVR) was recently approved by the FDA for intermediate risk patients with severe aortic stenosis (AS). This technique was already worldwide adopted for inoperable and high-risk patients. Improved device technology, imaging analysis and operator expertise has reduced the initial worrisome higher complications rate associated with TAVR, making it comparable to surgical aortic valve replacement (SAVR). However, many answers need to be addressed before adoption in lower risk patients. This paper highlights the pros and cons of TAVI based mostly on randomized clinical trials involving the two device platforms approved in the United States. We focused our analysis on metrics that will play a key role in expanding TAVR indication in healthier individuals. We review the significance and gave a perspective on paravalvular leak (PVL), valve performance, valve durability, leaflet thrombosis, stroke and pacemaker requirement.

Original languageEnglish (US)
Pages (from-to)444-452
Number of pages9
JournalAnnals of Cardiothoracic Surgery
Volume6
Issue number5
DOIs
StatePublished - Sep 1 2017
Externally publishedYes

Keywords

  • Leaflet thrombosis
  • Pacemaker
  • Paravalvular leak (PVL)
  • Paravalvular regurgitation
  • Review
  • Stroke
  • Surgical aortic valve replacement (SAVR)
  • Transcatheter aortic valve implantation (TAVI)
  • Transcatheter aortic valve replacement (TAVR)

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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