Transcatheter Aortic Valve Implantation

Transcatheter aortic valve implantation (TAVI) was first introduced by Alan Cribier in 2002.1 Since their introduction, the two available devices (the Cribier-Edwards aortic valve [Edwards Lifesciences] and the CoreValve [Medtronic]) have decreased in size and are more flexible, improving deliverability. It is estimated that >20 000 patients have had TAVI since it was first approved for use in Europe in 2007.2 Based on the results of the pivotal US Placement of Aortic Transcatheter Valve (PARTNERS) trial, the Sapien valve (an improved version of the Cribier-Edwards valve) was recommended for approval by the Food and Drug Administration Circulatory Systems Devices Panel on July 20, 2011 and awaits final Food and Drug Administration approval.3 It is widely anticipated that this valve will be available for use in the United States in 2012. There are >7 new valves in development that are expected to further improve deliverability and outcomes.The growth of TAVI is not surprising, because it can be categorized as a breakthrough technology. With the aging of the population, the number of elderly patients with severe symptomatic aortic stenosis has grown, and a significant proportion of high-risk patients are not candidates for surgical aortic valve replacement because of age and comorbidities. Without surgery, the outcome is extremely poor in such patients.4 Currently, …