Anexponential increase in the use of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis has been witnessedover the recent years. The current article reviews different areas of uncertainty related to patient selection. The use and limitations of risk scores are addressed, followed by an extensive discussion on the value of three-dimensional imaging for prosthesis sizing and the assessment of complex valve anatomysuch as degenerated bicuspid valves. Theuncertainty about valvular stenosis severity in patients with a mismatchbetweenthe transvalvular gradient and the aortic valve area, and how integrated use of echocardiography and computed tomographic imaging may help, is also addressed. Finally, patients referred for TAVI may have concomitant mitral regurgitation and/or coronary artery disease and the management of these patients is discussed.

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European Heart Journal
Erasmus MC: University Medical Center Rotterdam

Bax, J.J, Delgado, V, Bapat, V, Baumgartner, H, Collet, J.P, Erbel, R, … Windecker, S.W. (2014). Open issues in transcatheter aortic valve implantation. Part 1: patient selection and treatment strategy for transcatheter aortic valve implantation. European Heart Journal (Vol. 35, pp. 2627–2638). doi:10.1093/eurheartj/ehu256