Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Sep;6(5):444-452.
doi: 10.21037/acs.2017.09.15.

Pros and cons of transcatheter aortic valve implantation (TAVI)

Affiliations
Review

Pros and cons of transcatheter aortic valve implantation (TAVI)

Juan A Terré et al. Ann Cardiothorac Surg. 2017 Sep.

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).

PubMed Disclaimer

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.

Figures

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

References

    1. Athappan G, Patvardhan E, Tuzcu EM, et al. Incidence, predictors, and outcomes of aortic regurgitation after transcatheter aortic valve replacement: meta-analysis and systematic review of literature. J Am Coll Cardiol 2013;61:1585-95. 10.1016/j.jacc.2013.01.047 - DOI - PubMed
    1. Généreux P, Head SJ, Hahn RH, et al. Paravalvular Leak After TAVR. J Am Coll Cardiol 2013;61:1125-36. 10.1016/j.jacc.2012.08.1039 - DOI - PubMed
    1. Auffret V, Lefevre T, Van Belle E, et al. Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI. J Am Coll Cardiol 2017;70:42-55. 10.1016/j.jacc.2017.04.053 - DOI - PubMed
    1. Krasopoulos G, Falconieri F, Benedetto U, et al. European real world trans-catheter aortic valve implantation: systematic review and meta-analysis of European national registries. J Cardiothorac Surg 2016;11:159. 10.1186/s13019-016-0552-6 - DOI - PMC - PubMed
    1. Haensig M, Lehmkuhl L, Rastan AJ, et al. Aortic valve calcium scoring is a predictor of significant paravalvular aortic insufficiency in transapical-aortic valve implantation. Eur J Cardiothorac Surg 2012;41:1234-40; discussion 1240-1. 10.1093/ejcts/ezr244 - DOI - PubMed