Transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis.

Although surgery is the gold standard for severe aortic stenosis (AS) treatment, it is considered high risk in elderly patients because of high complication rates, which leads to substantial hesitation in submitting such patients to surgery. With the growing need to treat elderly patients with severe AS, percutaneous transcatheter aortic valve implantation (TAVI) was pioneered in 2001, followed by implantation of a self-expanding percutaneous aortic valve in 2005. As of April 2010, these 2 methods of TAVI have been used in more than 15,000 patients throughout the world. The acute success rate of this procedure is now increasing up to 95.4% by the transfemoral approach and 92.7% by the transapical approach with regard to Edwards SAPIEN valve implantation. In terms of the Corevalve ReValving system, it is reported as 98.2% in an expert's hands. This article reviews the methods of TAVI and the devices, not yet been approved in Japan but are expected to be available in a few years.