Transcatheter Aortic Valve Replacement

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2026 | Volume 2 | Issue 1 | Page 57 - 66

Dr. Armenian, Assistant Professor, Department of Cardiology, BSMCH, Bangladesh

Abstract

Transcatheter Aortic Valve Replacement (TAVR) has emerged as the definitive therapy for symptomatic severe aortic stenosis, fundamentally altering the management of valvular heart disease. Initially reserved for patients deemed "inoperable" or at prohibitive surgical risk, TAVR has expanded its clinical footprint through a series of landmark randomized trials—most notably the PARTNER and CoreValve series—to include intermediate and low-risk populations. This chapter evaluates the technical evolution of balloon-expandable and self-expanding valve platforms, the critical role of multi-modality imaging in procedural planning, and the management of "NextGen" complications such as paravalvular leak and conduction disturbances. We discuss the shift toward the "minimalist approach," involving conscious sedation and transthoracic echocardiographic guidance, which has reduced hospital stays to less than 48 hours. Furthermore, the chapter explores the emerging frontier of "Valve-in-Valve" procedures for degenerated surgical bioprostheses and the potential for TAVR in younger, low-risk cohorts. By synthesizing data up to 2026, this chapter provides a comprehensive roadmap of how TAVR transitioned from a "last-resort" experimental technique to a "first-line" global standard of care.