title: Transcatheter aortic valve replacement: current perspectives and future implications.
abstract: Transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) has emerged as an attractive treatment strategy for the treatment of patients with severe symptomatic aortic stenosis (AS), particularly those who are inoperable or at high risk for surgical aortic valve replacement. Several multicentre registries and randomised trials have demonstrated the safety and efficacy of this technology in improving the survival as well as functional capacity of patients with AS. Most of the elderly patients with severe AS have multiple non-cardiac comorbidities, which might limit survival and impede the improvement in functional capacity afforded by TAVR. Therefore, optimal patient selection based on precise risk assessment is currently the cornerstone of evaluation of patients for TAVR. Due to the need for a multifaceted approach in patient evaluation, procedural conduct as well as postprocedure management, multidisciplinary heart valve teams have assumed a paramount role in the TAVR process. This review presents the current perspectives in patient selection, risk assessment, procedural considerations and outcomes following TAVR, along with implications for the future.
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Shikhar
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Schoenhagen
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Stewart
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
authors.affiliation: Sones Cardiac Catheterization Laboratories, Department of Cardiovascular Medicine, J2-3, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D065467:Transcatheter Aortic Valve Replacement / Q000639:trends*