An Update on Transcatheter Aortic Valve Replacement

Abstract

Before the development of transcatheter aortic valve replacement (TAVR), patients with severe symptomatic aortic stenosis and significant comorbidities who were deemed inoperable were left with no therapeutic option but palliative care. Today, 11 years after Dr Alain Cribier's first transcatheter aortic valve implantation in 2002, more than 50,000 TAVRs have been performed worldwide, majority in Europe. Short-term results from the recently conducted Placement of Aortic Transcatheter Valve (PARTNER) I trial and long-term results from the European/Canadian registry experiences show significant reduction in mortality compared with medical therapy alone (inoperable cohort B) and noninferiority of TAVR versus open aortic valve replacement in high-risk patients (operable high-risk cohort A). Technical advances and increasing operator experience will further decrease procedure-related complications and may make TAVR an alternative to open aortic valve replacement in even younger and low- to medium-risk patients with severe symptomatic calcific aortic valve stenosis.