Long term TAVI: Only time will tell

Abstract

Transcatheter aortic valve implantation (TAVI) has been revolutionary in the treatment of severe symptomatic aortic stenosis. Given the excellent evidence available from randomised trials, we now know that TAVI is superior to medical treatment in patients unsuitable for surgery and is equivalent, or even superior, in patients with high [ [1] Adams D.H. Popma J.J. Reardon M.J. et al. Transcatheter aortic- valve replacement with a self-expanding prosthesis. N. Engl. J. Med. 2014; 370: 1790-1798 Crossref PubMed Scopus (2021) Google Scholar , [2] Smith C.R. Leon M.B. Mack M.J. et al. Transcatheter versus surgical aortic valve replacement in high-risk patients. N. Engl. J. Med. 2011; 364: 2187-2198 Crossref PubMed Scopus (4766) Google Scholar ], intermediate [ [3] Leon M.B. Smith C.R. Mack M.J. et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N. Engl. J. Med. 2016; 374: 1609-1620 Crossref PubMed Scopus (3203) Google Scholar , [4] Reardon M.J. Van Mieghem N.M. Popma J.J. et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N. Engl. J. Med. 2017; 376: 1321-1331 Crossref PubMed Scopus (1759) Google Scholar ] and low risk [ [5] Mack M.J. Leon M.B. Thourani V.H. et al. Transcatheter aortic- valve replacement with a balloon-expandable valve in low- risk patients. N. Engl. J. Med. 2019; 380: 1695-1705 Crossref PubMed Scopus (2388) Google Scholar , [6] Popma J.J. Deeb G.M. Yakubov S.J. et al. Transcatheter aortic- valve replacement with a self-expanding valve in low-risk patients. N. Engl. J. Med. 2019; 380: 1706-1715 Crossref PubMed Scopus (1832) Google Scholar ]. Rarely in medicine have such consistent results been seen across clinical trials. Yet there are still some questions that will only be answered with time, once more implantations have been performed. These areas of uncertainty are the long-term clinical outcomes, the durability of the prostheses and the long-term consequences of intraprocedural complications, such as pacemaker implantation and perivalvular aortic regurgitation. Finally, we must establish if there is a class effect between the different devices, particularly if the long-term results will differ depending on the type of prosthesis used. Long-term outcomes with balloon-expandable and self-expandable prostheses in patients undergoing transfemoral transcatheter aortic valve implantation for severe aortic stenosisInternational Journal of CardiologyVol. 290PreviewData on long-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is scarce. Full-Text PDF