In Percutaneous aortic valve replacement or Transcatheter Aortic Valve Implantation (TAVI), a replacement valve is passed through a hole in the groin by a puncture of the femoral artery and advanced up to the ascending aorta of the patient. It substitutes for a more invasive procedure in which the chest is opened. The survival is equivalent, but the risk of stroke is higher.

The catheter procedure was developed in Europe, initially performed in 2002. It is effective in improving functioning in the patients with severe aortic stenosis. It is still in clinical trial testing in the United States, and has not been approved by the FDA.

In high-risk patients with severe aortic stenosis, transcatheter and surgical procedures for aortic-valve replacement had similar rates of survival at 1 year, although there were important differences in risks associated with the procedure. The transcatheter procedure was associated with a higher risk of stroke than the surgical replacement (5.5% vs. 2.4% after 30 days; 8.3% vs. 4.3% after 1 year).

In 2010 good results (20% better 1 year survival) were reported from a US trial on 358 patients. The procedure was called transcatheter aortic-valve implantation (TAVI) and implanted cow heart valves.

Devices

There are two current market leaders whose devices have earned CE Mark approval in Europe and are available to physicians for implantation in appropriate patients; the CoreValve device (a self-expanding valve prosthesis consisting of a Nickel-titanium frame with a tri-leaflet valve fashioned out of porcine pericardium mounted within) and the SAPIEN device by Edwards Lifesciences (a balloon-expandable tubular metal stent with a tri-leaflet valve fashioned out of bovine percardium mounted within).