ABSTRACT
In 1960, the first aortic valve replacement was performed on cardiopulmonary bypass with a mechanical prosthesis. Five years later, the first tissue aortic valve made of porcine pericardium was successfully implanted. During the following 40 years, valve design was slow and iterative and the aortic valve procedure remained hostage to cardiopulmonary bypass. However, in 2002, the field was disruptively transformed when Cribier performed the first transcatheter aortic valve replacement (TAVR) in a patient who was inoperable for surgical aortic valve replacement (SAVR). This demonstration illustrated that acutely sick, high-risk patients with severe aortic valve stenosis could benefit from a minimally invasive catheter-based approach without cardiopulmonary bypass support. Since then, multiple randomized controlled trials have revealed the safety and efficacy of TAVR in high-and intermediate-risk patients. As patient populations around the world continue to age, TAVR will continue to be refined and increasingly used to treat aortic valve pathologies. Consequently, mastery of this procedure is paramount for all cardiothoracic surgery trainees and is a technique that should be embraced for appropriately selected patient populations.
