Transcatheter aortic valve implantation (TAVI) has evolved as a routine therapeutic option to treat elderly and high-risk patients with symptomatic aortic stenosis over recent years. Different prostheses with self-expandable nitinol frames or balloon expandable cobalt-chromium frames are available to be inserted by means of a retrograde transfemoral, retrograde transaortic, or an antegrade transapical approach. Current risks of TAVI include: malpositioning, particulate embolisation with subsequent stroke, vascular diseases, annular injury, or coronary obstruction, as well as the need for new onset pacemaker implantation; procedural complication rates for these remain at 5%. Second-generation valves, together with further technical developments, are expected to lead to easier and safer implantation techniques, translating into optimised outcomes for individual patients. The key to successful TAVI therapy is: joint pre-procedural indication, peri-procedural conduct, and post-procedural care of the patients by an experienced heart team.
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