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Terré JA, George I, Smith CR. Pros and cons of transcatheter aortic valve implantation (TAVI). Ann Cardiothorac Surg. 2017;6(5):444-452doi: 10.21037/acs.2017.09.15.
Terré, J. A., George, I., & Smith, C. R. (2017). Pros and cons of transcatheter aortic valve implantation (TAVI). Annals of cardiothoracic surgery, 6(5), 444-452. https://doi.org/10.21037/acs.2017.09.15
Terré, Juan A, et al. "Pros and cons of transcatheter aortic valve implantation (TAVI)." Annals of cardiothoracic surgery vol. 6,5 (2017): 444-452. doi: https://doi.org/10.21037/acs.2017.09.15
Terré JA, George I, Smith CR. Pros and cons of transcatheter aortic valve implantation (TAVI). Ann Cardiothorac Surg. 2017 Sep;6(5):444-452. doi: 10.21037/acs.2017.09.15. PMID: 29062739; PMCID: PMC5639221.
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Ann Cardiothorac Surg. 2017 Sep;6(5):444-452. doi: 10.21037/acs.2017.09.15.

Pros and cons of transcatheter aortic valve implantation (TAVI).

Annals of cardiothoracic surgery

Juan A Terré, Isaac George, Craig R Smith

Affiliations

  1. New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, USA.

PMID: 29062739 PMCID: PMC5639221 DOI: 10.21037/acs.2017.09.15

Abstract

Transcatheter aortic valve implantation (TAVI) or replacement (TAVR) was recently approved by the FDA for intermediate risk patients with severe aortic stenosis (AS). This technique was already worldwide adopted for inoperable and high-risk patients. Improved device technology, imaging analysis and operator expertise has reduced the initial worrisome higher complications rate associated with TAVR, making it comparable to surgical aortic valve replacement (SAVR). However, many answers need to be addressed before adoption in lower risk patients. This paper highlights the pros and cons of TAVI based mostly on randomized clinical trials involving the two device platforms approved in the United States. We focused our analysis on metrics that will play a key role in expanding TAVR indication in healthier individuals. We review the significance and gave a perspective on paravalvular leak (PVL), valve performance, valve durability, leaflet thrombosis, stroke and pacemaker requirement.

Keywords: Transcatheter aortic valve implantation (TAVI); leaflet thrombosis; pacemaker; paravalvular leak (PVL); paravalvular regurgitation; review; stroke; surgical aortic valve replacement (SAVR); transcatheter aortic valve replacement (TAVR)

Conflict of interest statement

Conflicts of Interest: Dr. George is a consultant for Edwards Lifesciences and Medtronic. The other authors have no conflicts of interest to declare.

References

  1. Am Heart J. 2005 Aug;150(2):288-93 - PubMed
  2. Circulation. 2007 Nov 27;116(22):2544-52 - PubMed
  3. JACC Cardiovasc Interv. 2009 Sep;2(9):821-7 - PubMed
  4. Catheter Cardiovasc Interv. 2010 May 1;75(6):873-4 - PubMed
  5. J Am Coll Cardiol. 2010 Jun 1;55(22):2413-26 - PubMed
  6. N Engl J Med. 2010 Oct 21;363(17):1597-607 - PubMed
  7. J Am Coll Cardiol. 2011 Jan 4;57(1):18-28 - PubMed
  8. N Engl J Med. 2011 Jun 9;364(23):2187-98 - PubMed
  9. Am J Cardiol. 2011 Dec 1;108(11):1600-5 - PubMed
  10. J Thorac Cardiovasc Surg. 2011 Nov;142(5):1229-35 - PubMed
  11. Eur J Cardiothorac Surg. 2012 Jun;41(6):1234-40; discussion 1240-1 - PubMed
  12. J Thorac Cardiovasc Surg. 2012 Apr;143(4):832-843.e13 - PubMed
  13. JACC Cardiovasc Interv. 2012 May;5(5):533-539 - PubMed
  14. JACC Cardiovasc Interv. 2012 May;5(5):540-551 - PubMed
  15. Eur Heart J. 2012 Oct;33(19):2403-18 - PubMed
  16. Circulation. 2012 Dec 18;126(25):3041-53 - PubMed
  17. J Am Coll Cardiol. 2013 Mar 19;61(11):1125-36 - PubMed
  18. Europace. 2013 Apr;15(4):531-40 - PubMed
  19. J Am Coll Cardiol. 2013 Apr 16;61(15):1585-95 - PubMed
  20. Can J Cardiol. 2013 Nov;29(11):1443-7 - PubMed
  21. J Am Coll Cardiol. 2014 Mar 25;63(11):1100-9 - PubMed
  22. N Engl J Med. 2014 May 8;370(19):1790-8 - PubMed
  23. J Am Coll Cardiol. 2014 Dec 23;64(24):2605-2615 - PubMed
  24. JACC Cardiovasc Interv. 2015 Jan;8(1 Pt A):60-9 - PubMed
  25. Catheter Cardiovasc Interv. 2015 Sep;86(3):518-27 - PubMed
  26. JACC Cardiovasc Imaging. 2015 Mar;8(3):340-60 - PubMed
  27. J Card Surg. 2015 Aug;30(8):631-9 - PubMed
  28. N Engl J Med. 2015 Nov 19;373(21):2015-24 - PubMed
  29. N Engl J Med. 2016 Apr 28;374(17):1609-20 - PubMed
  30. Lancet. 2016 May 28;387(10034):2218-25 - PubMed
  31. Eur Heart J. 2016 Jul 21;37(28):2252-62 - PubMed
  32. Health Technol Assess. 2016 Aug;20(60):1-260 - PubMed
  33. JAMA. 2016 Aug 9;316(6):592-601 - PubMed
  34. EuroIntervention. 2016 Sep 18;12(Y):Y33-6 - PubMed
  35. J Am Coll Cardiol. 2017 Jan 31;69(4):367-377 - PubMed
  36. Am Heart J. 2017 Feb;184:81-87 - PubMed
  37. J Cardiothorac Surg. 2016 Nov 29;11(1):159 - PubMed
  38. JACC Cardiovasc Imaging. 2016 Dec 8;:null - PubMed
  39. Circ Cardiovasc Interv. 2017 Jan;10(1): - PubMed
  40. J Am Coll Cardiol. 2017 Jan 31;69(4):465-466 - PubMed
  41. N Engl J Med. 2017 Apr 6;376(14):1321-1331 - PubMed
  42. Lancet. 2017 Jun 17;389(10087):2383-2392 - PubMed
  43. Stroke. 2017 May;48(5):1306-1315 - PubMed
  44. J Am Coll Cardiol. 2017 Apr 25;69(16):2067-2087 - PubMed
  45. Circ Cardiovasc Imaging. 2017 May;10(5):null - PubMed
  46. J Am Coll Cardiol. 2017 Jul 4;70(1):42-55 - PubMed
  47. J Thorac Cardiovasc Surg. 2017 Dec;154(6):1872-1880.e1 - PubMed
  48. JACC Cardiovasc Interv. 2017 Aug 14;10(15):1578-1587 - PubMed
  49. Catheter Cardiovasc Interv. 2017 Nov 1;90(5):870-877 - PubMed
  50. Am Heart J. 2018 Jun;200:44-50 - PubMed

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