title: Transcatheter Aortic Valve Replacement 2016: A Modern-Day "Through the Looking-Glass" Adventure.
abstract: Transcatheter aortic valve replacement (TAVR) has become a safe and effective therapy for patients with severe aortic stenosis (AS). In recent trials, the hemodynamic performance and clinical outcomes of the latest generation of TAVR devices demonstrated at least parity with surgical outcomes in patients of similar risk. Many initial obstacles with TAVR have largely been overcome, including frequent access site complications and concerns about strokes and paravalvular leaks. Using a multidisciplinary heart team approach, patient selection, procedural planning, and device implantation have been refined and optimized such that clinical outcomes are generally predictable and reproducible. Future research will focus on the durability of TAVR devices, further enhancements in clinical outcomes, and adjunctive therapies. On the basis of initial results from ongoing clinical trials, the indication for TAVR will likely expand to lower-risk patients. This review provides an overview of recent progress in this field, and highlights future opportunities and directions.
authors.affiliation: Columbia University Medical Center, New York Presbyterian Hospital, and Cardiovascular Research Foundation, New York, New York. Electronic address: tv2193@columbia.edu.
authors.forename: Torsten P
authors.initials: TP
authors.lastname: Vahl
authors.affiliation: Columbia University Medical Center, New York Presbyterian Hospital, and Cardiovascular Research Foundation, New York, New York.
authors.forename: Susheel K
authors.initials: SK
authors.lastname: Kodali
authors.affiliation: Columbia University Medical Center, New York Presbyterian Hospital, and Cardiovascular Research Foundation, New York, New York.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D001024:Aortic Valve Stenosis / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D018579:Patient Selection; D012307:Risk Factors; D065467:Transcatheter Aortic Valve Replacement / Q000639:trends*
keywords: aortic stenosis; coronary artery disease; heart valve diseases; mitral valve; transcatheter heart valve