title: Transcatheter aortic valve replacement: where will we be in 5 years?
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) has developed in less than 2 decades to be a viable procedure, carving out a niche position in our armamentarium to treat high-risk patients with aortic valve disease. Rapid advances are occurring in prosthesis design, catheter delivery system, imaging, and the hybrid operating room.
  
  
  RESULTS
  The PARTNER (Placement of AoRTic traNscathetER valve) randomized trial, cohort B confirms the superiority of the transfemoral TAVI compared with standard medical therapy with regard to overall survival and cardiac functional status. Major stroke and vascular complications, however, remain higher in the transfemoral TAVI group. Large European registries of both the transapical and transfemoral TAVI are reporting improved procedural success and early survival. The CoreValve and SAPIEN valves remain the forerunners, with accumulating evidence for use, and published 3-year prosthesis durability data for the latter.
  
  
  CONCLUSIONS
  Evidence is accumulating in support of TAVI for high-risk nonoperative aortic stenosis. Even before the PARTNER cohort A results, comparing TAVI and conventional aortic valve replacement, become available, the next generation devices and technological improvements are well underway to make the procedure even more reproducible.
authors.affiliation: Division of Cardiovascular Surgery, St Paul's Hospital, Burrard Street, Vancouver. acheung@providencehealth.bc.ca
authors.forename: Anson
authors.initials: A
authors.lastname: Cheung
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Soon
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods; D003199:Computer Systems; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D006801:Humans; D013997:Time Factors