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Ann Cardiothorac Surg. 2017 Sep;6(5):444-452. doi: 10.21037/acs.2017.09.15.

Pros and cons of transcatheter aortic valve implantation (TAVI).

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1
New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, USA.

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.

KEYWORDS:

Transcatheter aortic valve implantation (TAVI); leaflet thrombosis; pacemaker; paravalvular leak (PVL); paravalvular regurgitation; review; stroke; surgical aortic valve replacement (SAVR); transcatheter aortic valve replacement (TAVR)

Conflict of interest statement

Conflicts of Interest: Dr. George is a consultant for Edwards Lifesciences and Medtronic. The other authors have no conflicts of interest to declare.

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