Transcatheter aortic valve implantation: Miracle of heart surgery


  • Hani Abu Tziam Department of Family Medicine, Clalit City, Lod, Israel



Aortic stenosis, transcatheter aortic valve implantation, vascular


Patients with severe aortic stenosis (AS) who are ineligible for surgery due to technical/anatomical complications or significant surgical risk can now get transcatheter aortic valve implantation (TAVI), a fast-developing therapeutic option. When practical, the transfemoral technique is the preferred TAVI delivery method. Transaortic, trans-subclavian, and transapical access are other non-transfemoral access possibilities. The transcarotid, transcaval, and antegrade aortic methods are also viable, although they are only available to experienced surgeons and medical facilities. It is essential to thoroughly evaluate the patient's atherosclerotic load and location, arterial size and tortuosity, and the presence of mural thrombus due to the unique characteristics of each vascular approach created for TAVI delivery. Several clinical trials are presently being conducted, and in the near future, it is anticipated that the indications for these methods will be clarified and expanded to a wider range of TAVI candidates.


Edwards FH, Peterson ED, Coombs LP, DeLong ER, Jamieson WR, Shroyer ALW, et al. Prediction of operative mortality after valve replacement surgery. J Am Coll Cardiol. 2001;37(3):885-92.

Zoltowska DM, Agrawal Y, Patel N, Sareen N, Kalavakunta JK, Gupta V, et al. Association Between Pulmonary Hypertension and Transcatheter Aortic Valve Replacement: Analysis of a Nationwide Inpatient Sample Database. Rev Recent Clin Trials. 2019;14(1):56-60.

Iantorno M, Ben-Dor I, Rogers T, Gajanana D, Attaran S, Buchanan KD, et al. Emergent valve-in-valve transcatheter aortic valve replacement in patient with acute aortic regurgitation and cardiogenic shock with preoperative extracorporeal membrane oxygenator: A case report and review of the literature. Cardiovasc Revasc Med. 2018;19(8S):68-70.

Henn MC, Zajarias A, Quader N, Sintek M, Lasala JM, Koogler K, et al. Observed to expected 30-day mortality as a benchmark for transcatheter aortic valve replacement. J Thorac Cardiovasc Surg. 2019;157(3):874-82.e8.

Loukas M, Bilinsky E, Bilinsky S, Blaak C, Tubbs RS, Anderson RH. The anatomy of the aortic root. Clin Anat. 2014;27(5):748-56.

Lateef N, Khan MS, Deo SV, Yamani N, Riaz H, Virk HUH, et al. Meta-Analysis Comparing Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation With Versus Without Percutaneous Coronary Intervention. Am J Cardiol. 2019;124(11):1757-64.

Edelman JJ, Thourani VH. Transcatheter aortic valve replacement and surgical aortic valve replacement: Both excellent therapies. J Thorac Cardiovasc Surg. 2018;156(6):2135-7.

Gillam LD, Marcoff L. Echocardiographic Assessment of Transcatheter Aortic Valve Hemodynamics: More Tools for the Toolbox. JACC Cardiovasc Imaging. 2019;12(1):35-37.

Lardizabal JA, O'Neill BP, Desai HV, Macon CJ, Rodriguez AP, Martinez CA, et al. The transaortic approach for transcatheter aortic valve replacement: initial clinical experience in the United States. J Am Coll Cardiol. 2013;61(23):2341-5.

Biasco L, Ferrari E, Pedrazzini G, Faletra F, Moccetti T, Petracca F, et al. Access Sites for TAVI: Patient Selection Criteria, Technical Aspects, and Outcomes. Front Cardiovasc Med. 2018;5:88.

Chow SC, Cheung GS, Lee AP, Wu EB, Ho JY, Kwok MW, et al. Transcatheter aortic valve implantation: the transaortic approach. Asian Cardiovasc Thorac Ann. 2017;25(5):357-63.

Dunne B, Tan D, Chu D, Yau V, Xiao J, Ho KM, et al. Transapical Versus Transaortic Transcatheter Aortic Valve Implantation: A Systematic Review. Ann Thorac Surg. 2015;100(1):354-61.

Bonacchi M, Prifti E, Giunti G, Frati G, Sani G. Does mini sternotomy improve postoperative outcome in aortic valve operation? A prospective randomized study. Ann Thorac Surg. 2002;73(2):460-5.

Stastny L, Krapf C, Dumfarth J, Gasser S, Bauer A, Friedrich G, et al. Minireview: Transaortic Transcatheter Aortic Valve Implantation: Is There Still an Indication? Front Cardiovasc Med. 2022;9:798154.

Pagotti MD, Bueno SCP, Gomes CIG, Oliveira PA de, Scanavacca MI, Hachul DT. The Importance of Adequate Programming Dual-Chamber Pacemaker in Physically Active Patients . J Clin Tri Exp Invest. 2022;1(1):22-7.




How to Cite

Abu Tziam H. Transcatheter aortic valve implantation: Miracle of heart surgery. Unicos Rev [Internet]. 2022 Dec. 6 [cited 2024 Apr. 18];1(1-2):20-3. Available from: