Evolution of Transcatheter Aortic Valve Replacement

• Published in: Circulation research Vol. 114; no. 6; pp. 1037 - 1051
• Main Authors: Bourantas, Christos V., Serruys, Patrick W.
• Format: Journal Article
• Language: English
• Published: United States American Heart Association, Inc 14.03.2014
• Subjects: Aortic Valve - surgery; Arrhythmias, Cardiac - etiology; Cardiac Catheterization; Clinical Trials as Topic; Endovascular Procedures - instrumentation; Endovascular Procedures - methods; Endovascular Procedures - trends; Equipment Design; Equipment Failure; Heart Diseases - etiology; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - trends; Humans; Minimally Invasive Surgical Procedures; Multicenter Studies as Topic; Pacemaker, Artificial; Patient Selection; Platelet Aggregation Inhibitors - therapeutic use; Postoperative Complications; Premedication; Prognosis; Randomized Controlled Trials as Topic; Stroke - etiology; Stroke - prevention & control; aortic valve stenosis; prognosis
• ISSN: 0009-7330; 1524-4571; 1524-4571
• DOI: 10.1161/CIRCRESAHA.114.302292

Transcatheter aortic valve replacement emerged ≈20 years ago and changed the landscape of structural interventional cardiology. The first experiments in animal models provided proofs of the concept and the substrate for the first percutaneous valve implantation in patients. The initial promising results in a clinical setting drew the attention of the industry and of the scientific community, and an effort was made for the past 12 years to address the limitations of the technology, facilitate the procedure, minimize the risk of complications, and broaden the applications of transcatheter aortic valve replacement. This article reviews the evolution of transcatheter aortic valve replacement, presents the first steps in this field, cites the evidence from registries and clinical trials, highlights the limitations of this treatment, and discusses the future perspectives and the developments proposed to address the current pitfalls.