Transcatheter Aortic Valve Implantation/ Replacement (Tavi/ Tavr): How It Started, How Its Going, Where Its Going

Transcatheter Aortic Valve Implantation/ Replacement (TAVI/TAVR) has come a long was since the first in human implant done by Prof Cribier & colleagues in 2002. Initially a consideration in inoperable/ high surgical risk patients, TAVI is now indicated in patients with severe tricuspid aortic stenosis and suitable anatomy aged 70 or higher. This has been possible due to improvements in pre procedural planning, performance upgrades & evolution of transcatheter heart valve (THV) systems and increasing operator experience. Considering improving longevity and relatively younger ages at index implantation, complexities of redo TAVI planning and methods to improve THV durability are the next frontiers. This review summarizes these advancements while emphasizing on pre procedural planning, current guidelines, individualized device selection with a brief note on polymeric heart valves - developed to overcome the disadvantageous bioprosthetic dysfunction seen with current THVs.