Evolving Indications for Transcatheter Aortic Valve Interventions.

Abstract

The purpose of this review was to summarize recent progress in the field of transcatheter aortic valve replacement (TAVR), discuss expansion of indications, and identify areas of future clinical applications. Favorable clinical outcomes as well as continued refinement of transcatheter heart valve technology have prompted the continuous expansion of indications for TAVR. The results of randomized clinical trials comparing the safety and efficacy of TAVR relative to conventional surgical aortic valve replacement (SAVR) in lower- than high-risk patients have recently been published, and trials among lower-risk categories are ongoing. Furthermore, evidence of the feasibility and safety of TAVR in patients with other pathological conditions is accumulating. Large pivotal randomized studies support the extension of TAVR to intermediate-risk patients. Moreover, TAVR is emerging as a valuable treatment option for other categories including patients with bicuspid aortic valve, those with pure native aortic regurgitation deemed inoperable, and those with degenerated surgical bioprosthetic valves.