Transcatheter Aortic Valve Replacement: Review Article

Abstract

Over the past two decades, the field of transcatheter aortic valve replacement (TAVR) has undergone significant advancement, driven by both technological innovation and procedural refinement. Once a procedure that was conducted under general anesthesia in an operating room followed by a 5+-day hospital stay is now predominantly being done using moderate sedation in a catheterization laboratory, with many patients being discharged home the following day. Several factors have contributed to this transformation. These include the expansion of TAVR to lower-risk patient populations, reductions in delivery system size facilitating broader use of transfemoral access, and the implementation of streamlined care pathways such as the 3M approach—multidisciplinary, multimodality, but minimalist. This minimalist strategy has been pivotal in enhancing procedural efficiency and reducing resource utilization without compromising outcomes. As a result, TAVR volumes have grown exponentially in recent years and are expected to continue rising, particularly as the procedure is investigated for new indications such as moderate aortic stenosis and asymptomatic severe aortic stenosis. Central to the success of TAVR is a comprehensive assessment of each patient’s suitability for valve replacement, performed by a multidisciplinary heart valve team. Key Wards: Aortic stenosis, transcatheter aortic valve replacement, current situation.