Transcatheter Aortic Valve Interventions and Outcomes

Transcatheter aortic valve implantation (TAVI) has transformed the management of severe aortic stenosis by offering a minimally invasive alternative to surgical aortic valve replacement (SAVR). Initially reserved for patients at prohibitive surgical risk, indications have rapidly expanded to include intermediate and low-risk cohorts. Contemporary valve designs—both balloon-expandable and self-expanding—have refined anchoring, reduced paravalvular regurgitation and minimised conduction disturbances. Imaging advances, particularly in computed tomography and magnetic resonance, enable precise annular sizing and assessment of left ventricular remodelling. Long-term studies reveal comparable survival to SAVR, with lower rates of structural valve deterioration but evolving concerns regarding leaflet thrombosis and bioprosthetic degeneration. Patient selection increasingly incorporates markers of myocardial health, including extracellular volume fraction, to optimise timing of intervention. Global uptake has been fuelled by reduced hospital stays, enhanced quality of life and broadened applicability to bicuspid valve anatomy. Ongoing refinements in procedural technique, device innovation and post-implantation surveillance underpin a dynamic field aimed at durable, patient-centred care.

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Transcatheter Aortic Valve Interventions and Outcomes publication trend

The graph below shows the total number of articles in transcatheter aortic valve interventions and outcomes across all publications each year (not limited to Nature Index journals).

Technical terms

Transcatheter aortic valve implantation (TAVI): A minimally invasive procedure to replace a stenotic aortic valve via catheter-based delivery of a bioprosthetic valve.

Surgical aortic valve replacement (SAVR): Conventional open-heart surgery involving excision of the native valve and implantation of a prosthetic valve.

Structural valve deterioration (SVD): Progressive degeneration of a bioprosthetic valve leading to leaflet thickening, calcification or dysfunction.

Extracellular volume fraction (ECV%): A cardiac magnetic resonance metric quantifying diffuse myocardial fibrosis by measuring the proportion of extracellular matrix.

Paravalvular regurgitation (PVR): Leakage around the implanted valve due to incomplete sealing between the prosthesis and native annulus.

References

1. Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial. European Heart Journal (2024).
2. Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Disease. Journal of the American College of Cardiology (2014).
3. Left ventricular remodeling and hypertrophy in patients with aortic stenosis: insights from cardiovascular magnetic resonance. Journal of Cardiovascular Magnetic Resonance (2012).
4. Extracellular Myocardial Volume in Patients With Aortic Stenosis. Journal of the American College of Cardiology (2020).
5. CT and MR imaging prior to transcatheter aortic valve implantation: standardisation of scanning protocols, measurements and reporting—a consensus document by the European Society of Cardiovascular Radiology (ESCR). European Radiology (2019).
6. 1-Year Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves Results From the CHOICE Randomized Clinical Trial. Journal of the American College of Cardiology (2015).