The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

INTERVENTIONS FOR VALVULAR DISEASE AND HEART FAILURE

The evolution of device technology in transcatheter aortic valve implantation

EuroIntervention 2019;14:e1826-e1833 published online February 2019. DOI: 10.4244/EIJ-D-18-01048

1. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; 2. Institute of Cardiovascular Sciences, University College London, London, United Kingdom; 3. School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom; 4. Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 5. Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 6. Department of Cardiology, St Thomas’ Hospital, London, United Kingdom; 7. International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom

Transcatheter aortic valve implantation (TAVI) has rapidly evolved and changed the landscape of structural interventional cardiology. Advances in transcatheter heart valve (THV) prostheses and TAVI-enabling devices have simplified the procedure, reduced the risk of complications, improved short- and long-term outcomes and broadened the applications of TAVI, not only in challenging patients and complex anatomies but also in intermediate-risk or even in low-risk patients, where surgical valve replacement constitutes an effective and well-established therapy. In this review article, we provide an overview of the developments in TAVI devices which have played a vital role in TAVI evolution: we describe the prostheses that failed to reach clinical practice, we present the characteristics of the first valves that were tested in the clinical arena, we summarise the evidence from the first studies that highlighted the potential but also the limitations of TAVI, and we present the advanced next-generation THV prostheses that have an improved performance and safety profile.

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