Transcatheter aortic valve implantation in low-risk patients: A case of rational over exuberance. The time is not now.

BACKGROUND

Review of evidence and concerns, relating to extension of transcatheter aortic valve implantation usage to low-risk patients.

METHODS

Comprehensive literature review was conducted identifying articles relating to transcatheter aortic valve implantation.

RESULTS

Transcatheter aortic valve implantation is effective in patients with aortic stenosis. Currently, long-term durability and cost-effectiveness are unproven, anticoagulation requirement undefined, permanent pacemaker implantation and paravalvular leak rates higher than following surgical aortic valve replacement.

CONCLUSIONS

Current evidence supporting transcatheter aortic valve implantation usage in low-risk patients is insufficient. Extending use now, to this large young patient population is premature, and should be delayed.