10 Sep 2025
Transcatheter aortic valve implantation (TAVI)
The PCR Textbook
Aortic stenosis (AS) is the most common valvular heart disease leading to intervention. It is characterized by progression from leaflet thickening and calcification to significant haemodynamic stenosis which results in disease-specific symptoms and physical limitations as well as poor prognosis and impaired quality of life if left untreated.
In 1986, Cribier and colleagues introduced balloon aortic valvuloplasty as treatment for inoperable patients with severe AS. Although balloon aortic valvuloplasty achieved favourable acute haemodynamic outcomes, restenosis and clinical deterioration occurred frequently within 6-12 months requiring repeat interventions. In 2002, Cribier and colleagues performed the first in-human transcatheter aortic valve implantation (TAVI) using a 24 Fr catheter delivery system housing a 23 mm bovine pericardial balloon-expandable stent valve in a 57-year-old critically ill patient presenting with cardiogenic shock due to severe AS who had failed balloon valvuloplasty. The intervention was successful in restoring stable haemodynamics leading to subsequent feasibility studies with the balloon-expandable transcatheter heart valve (THV)...
Authors
Daijiro Tomii, Thomas Pilgrim, Jonas Lanz, Taishi Okuno, Stephan Windecker
