Decision making in TAVI: ensuring the best possible clinical outcomes based on the selection of patients and techniques

Severe aortic stenosis is associated with high mortality and morbidity. Furthermore, it is the most common valvular abnormality in the developed world. Many patients do not have conventional surgical aortic valve replacement as a result of advanced age and comorbidity. Transcatheter aortic valve implantation (TAVI) is a viable alternative in this patient group, and has been recommended in patients with high surgical risk. Current guidelines for preassessment and patient selection are based on the initial TAVI studies assessing short- and longer-term outcome following valve implantation and were introduced to improve procedural success. The choice of the specific valve and delivery method is also very important in determining the clinical outcome, and requires a thorough evaluation preprocedure. This article reviews the current recommended guidelines for patient selection for TAVI, and their applications and limitations in the context of current clinical practice. As experience in the field grows, TAVI is ...