title: Remaining pitfalls and limitations of TAVI in 2014.
abstract: Transcatheter aortic valve implantation (TAVI) has become a feasible and effective therapeutic option for patients with severe aortic stenosis and high operative risk or relative contraindications for surgical aortic valve replacement (SAVR). However, as with every new technology, a number of potential pitfalls and limitations have to be addressed and future opportunities have to be clarified in well-conducted clinical trials and well-monitored registries. Procedural issues are still controversial, and technical and procedural enhancements are required to reduce complications. Moreover, further studies are essential to evaluate second-generation devices in a broader patient population in order to understand whether the theoretical benefits of improved valve designs translate into fewer complications and a better long-term survival. Adjunctive devices, such as cerebrovascular protection devices, have to be further evaluated in clinical trials. This manuscript will focus on current procedural and post-procedural limitations of TAVI and future opportunities to overcome those challenges.
authors.affiliation: University of Leipzig, Heart Center, Department of Internal Medicine/Cardiology, Leipzig, Germany.
authors.forename: Norman
authors.initials: N
authors.lastname: Mangner
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Axel
authors.initials: A
authors.lastname: Linke
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D006327:Heart Block / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D020521:Stroke / Q000209:etiology; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*