TAVI / TAVR / PAVR
Catheter based, transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI). The replacement valve is delivered via one of several access methods like, a) transfemoral (in the upper leg), b) transapical (through the wall of the heart), c) subclavian (beneath the collar bone), d) direct aortic (through a minimally invasive surgical incision into the aorta), and d) transcaval (from a temporary hole in the aorta near the belly button through a vein in the upper leg). Severe symptomatic aortic stenosis carries a poor prognosis. Until recently, surgical aortic valve replacement has been the standard of care in adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure or coronary artery disease, as well as in people with comorbidities such as cerebrovascular and peripheral arterial disease, chronic kidney disease, and chronic respiratory dysfunction specially in octogenarian patients.