Transcatheter aortic valve implantation (TAVI) has evolved as one of the most important innovations in cardiovascular medicine during the past five years. By means of transfemoral (TF) and transapical (TA) AVI elderly and high-risk patients with symptomatic aortic stenosis (AS) are being routinely treated using a minimally invasive approach. Some challenges have to be overcome to obtain perfect results: patient screening and eventual selection is important, conduct of the procedures by an experienced and interdisciplinary heart team is ideal and intense post-operative therapy is required for the patients. Currently available devices, the Corevalve™ (CV, Medtronic Inc.) and SAPIEN™ (ES, Edwards Inc.) prostheses, which are Conformité Européenne (CE) Mark approved for TF (CV and ES) and TA (ES) implantations, are first-generation prostheses. Future developments will focus on reduction of potential paravalvular leakage as well as improved features during valve implantation, most importantly repositioning and retrievability. TAVI has already gained an important position for the treatment of elderly high-risk patients with AS.
Cost-effectiveness of transcatheter aortic valve implantation (TAVI) for aortic stenosis in patients who are high risk or contraindicated for surgery: a model-based economic evaluation
