title: Transcatheter aortic valve implantation: current trends and future directions.
abstract: Transcatheter aortic valve implantation (TAVI) has been increasingly utilized for the treatment of severe symptomatic aortic stenosis in inoperable and high surgical risk patients. Recent advances in valve technology include repositionable scaffolds and smaller delivery systems, as well as improvement in periprocedural imaging. These advances have resulted in reduction of vascular complications, rates of paravalvular aortic regurgitation and periprocedural stroke and improved overall outcomes. Increasingly, TAVI is the preferred treatment for high-risk surgical patients with severe aortic stenosis. Consequently, there is growing interest for the use of TAVI in lower surgical risk patients. Furthermore, the role of TAVI has expanded to include valve-in-valve procedures for the treatment of degenerative bioprosthetic valves and bicuspid aortic valves. Questions remain in regard to the optimal management of concurrent coronary artery disease, strategies to minimize valve leaflet restriction and treatment of conduction abnormalities as well as identifying newer indications for its use.
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Usaid K
authors.initials: UK
authors.lastname: Allahwala
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Danson
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Straiton
authors.affiliation: Department of Cardiology, Flinders Medical Centre, Adelaide, Australia.
authors.forename: Ajay
authors.initials: A
authors.lastname: Sinhal
authors.affiliation: Department of Cardiology, The Prince Charles Hospital, Brisbane, Australia.|The University of Queensland, Brisbane, Australia.
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
authors.affiliation: Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
authors.forename: Ravinay
authors.initials: R
authors.lastname: Bhindi
mesh_terms: D000772:Anesthesia, Local; D001024:Aortic Valve Stenosis / Q000601:surgery*; D016292:Procedural Sedation; D003327:Coronary Disease / Q000150:complications; D005544:Forecasting; D006350:Heart Valve Prosthesis; D006801:Humans; D010348:Patient Care Team; D011183:Postoperative Complications; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D065467:Transcatheter Aortic Valve Replacement / Q000639:trends*
keywords: aortic stenosis; paravalvular aortic regurgitation; surgical aortic valve replacement; transcatheter aortic valve implantation; transcatheter aortic valve replacement; valve-in-valve procedure