Transcatheter aortic valve implantation

Aortic stenosis (AS) is the most common valvular heart disease leading to intervention. It is characterized by progression from leaflet thickening and calcification to significant haemodynamic stenosis which results in disease-specific symptoms and physical limitations as well as poor prognosis and impaired quality of life if left untreated. 

In 1986, Cribier and colleagues introduced balloon aortic valvuloplasty as treatment for inoperable patients with severe AS11. Cribier A, Savin T, Saoudi N, et al. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement. Lancet. 1986;1:63-67 Link. Although balloon aortic valvuloplasty achieved favourable acute haemodynamic outcomes, restenosis and clinical deterioration occurred frequently within 6-12 months requiring repeat interventions2, 32. Litvack F, Jakubowski AT, Buchbinder NA, Eigler N. Lack of sustained clinical improvement in an elderly population after percutaneous aortic valvuloplasty. Am J Cardiol. 1988;62:270-275 Link3. Lieberman EB, Bashore TM, Hermiller JB, et al. Balloon aortic valvuloplasty in adults: failure of procedure to improve long-term survival. J Am Coll Cardiol. 1995;26:1522-1528 Link. In 2002, Cribier and colleagues performed the first in-human transcatheter aortic valve implantation (TAVI) using a 24 Fr catheter delivery system housing a 23 mm bovine pericardial balloon-expandable...