April 22, 2026European Heart Journal74 citationsOpen Access
View Full PaperTranscatheter aortic valve implantation in lower-risk patients: what is the perspective?
Key Result
Transcatheter aortic valve implantation is being evaluated as an alternative to surgical aortic valve replacement in low- to intermediate-risk patients with severe aortic stenosis.
Key Points
- To examine the role of transcatheter aortic valve implantation (TAVI) in low-risk patients and summarize existing knowledge.
- Discussed guidelines equating TAVI and SAVR for high-risk patients.
- Reviewed recent randomized controlled trials and advancements in transcatheter heart valves.
- Explored ongoing randomized trials focused on low-risk patient populations.
- TAVI has shown excellent outcomes in intermediate-risk subjects, supporting its expanded indication.
- Guidelines recommend TAVI as equivalent to SAVR in high-risk patients, influencing its adoption.
- Potential advantages of TAVI in low-risk patients need to be weighed against possible pitfalls.
Structured PICO
Does transcatheter aortic valve implantation (TAVI) provide advantages over surgical aortic valve replacement (SAVR) in low- to intermediate-risk patients with symptomatic severe aortic stenosis?
P
Population
Low- to intermediate-risk patients with symptomatic severe aortic stenosis
I
Intervention
Transcatheter aortic valve implantation (TAVI)
C
Comparator
Surgical aortic valve replacement (SAVR)
This review highlights the expanding role of TAVI into lower-risk populations with severe aortic stenosis, discussing potential advantages and challenges.
Abstract
In the last decade, transcatheter aortic valve implantation (TAVI), a disruptive technology, has revolutionized the therapy of symptomatic severe aortic stenosis, and current guidelines state that the recommendations for TAVI and surgical aortic valve replacement (SAVR) are equivalent in patients at high-risk. Increased operator experience, technical advances in the new generation of transcatheter heart valves (THV) and excellent TAVI results in recently published randomized controlled trials have led to the expansion of TAVI indication as an alternative to SAVR in intermediate-risk subjects, given appropriate patient selection. The time is opportune to examine the role of TAVI in low-risk patients, currently the objective of on-going randomized trials. This review aims to summarize the available knowledge on TAVI in low- to intermediate-risk patients and to discuss the potential advantages and pitfalls TAVI will face in this clinical setting.