Unmet issues in transcatheter aortic valve implantation

Over the last 15 years, we have seen a rapid and exponential uptake of transcatheter aortic valve implantation (TAVI) for the treatment of patients with severe symptomatic aortic stenosis (1). This uptake has also been coupled with the evolution and advancement in transcatheter valve technologies. As such, a number of new TAVI devices have also been marketed, mainly with the aim of diminishing problems faced with first generation devices; notably, smaller delivery systems, less incidence of paravalvular leak (PVL) or need for permanent pacemaker implantation (PPI) and other device- or procedural related complications (2,3).