# From an Unfolding Emergency Treatment to a Universal Shift in Therapy: The History and Evolution of the Catheter-Based Treatment of Aortic Valve Stenosis

## TL;DR

This paper reviews the history and development of catheter-based treatments for aortic valve stenosis, highlighting the shift from surgery to minimally invasive options.

## Contribution

The paper provides a comprehensive historical overview of the evolution of transcatheter aortic valve implantation (TAVI) as a treatment for aortic valve stenosis.

## Key findings

- Transcatheter aortic valve implantation (TAVI) has become an equivalent treatment for high-risk surgical patients.
- Early TAVI concepts and their amendments paved the way for a revolutionary diversification in AVS treatment.
- Transcatheter aortic balloon valvuloplasty provided the impetus for further interventional approaches to AVS therapy.

## Abstract

Aortic valve stenosis (AVS) is the most frequent valvular heart disease in
industrialized countries, presenting with very high mortality if left untreated.
While drug treatment can sometimes alleviate symptoms, it fails to stop
progression or cure the underlying disease. Until the first decade of this
millennium, surgical aortic valve replacement (SAVR) remained the only available
therapy option with a positive impact on mortality and morbidity. Even though
several studies reported highly positive effects of SAVR regarding the improved
quality of life and better physical performance, SAVR remained an intervention
that, due to its remarkable complexity and the need for heart-lung machine and
cardioplegia, was limited by the patients’ comorbid profile. While
unsatisfying hemodynamic results after transcatheter aortic balloon valvuloplasty
in high-risk surgical patients limited its adoption as an alternative treatment,
it provided the impetus for further interventional approaches to the therapy of
AVS. This review considers the invention and development of transcatheter aortic
valve implantation (TAVI), which established itself as a catheter-based,
minimally invasive procedure over the past decade, and has become an equivalent
treatment method for high-risk surgical patients. For that matter, early TAVI
concepts, their amendments, and the associated pioneers are recognized for paving
the way to a revolutionary diversification in AVS treatment.