TAVI

TAVI, also known as transcatheter aortic valve implantation or transcatheter aortic valve replacement (TAVR in some regions), is a minimally invasive method to replace a diseased aortic valve without open-heart surgery. It is primarily used to treat severe aortic stenosis in patients considered high risk for conventional surgical valve replacement, but its use has broadened to a wider range of risk profiles as evidence has accumulated. The procedure delivers a bioprosthetic valve to the aortic position via a catheter, usually through the femoral artery, with alternative access options available.

The procedure involves delivering a bioprosthetic valve to the aortic position via a catheter. Access is usually through the femoral artery, but alternative routes such as transapical, transaortic, transcarotid, or transcaval can be used when the femoral approach is unsuitable. Valves are of two main types: balloon-expandable and self-expanding, with ongoing refinements in design to improve fit and reduce leaks. The native valve is often left in place as a scaffold.

Patient selection weighs age, comorbidity, frailty, and anatomic suitability. Benefits include relief of symptoms, improved functional status, and potential survival advantage in appropriate groups, with shorter hospital stays compared with open surgery. Risks include vascular complications, stroke, paravalvular leak, and the need for a permanent pacemaker; durability and long-term outcomes depend on valve type and patient factors.

TAVI has become a standard option in major guidelines for severe aortic stenosis and continues to be studied in randomized trials to define best-use scenarios across risk groups and valve types.