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Aortic stenosis has emerged as a global pandemic with the ageing population and has become the third leading cause of structural heart disease after hypertension and coronary artery disease in industrialized countries. Older age and presence of serious comorbid conditions make surgery prohibitively risky in a large group of patients. The long-term results of balloon aortic valvuloplasty have been unsatisfactory, limiting the use of this procedure to only palliation or as a bridge to surgery. Percutaneous aortic prosthetic valve implantation has emerged as a new treatment modality for patients who are not eligible for surgery. After the first successful human application in 2002, transcatheter aortic valve implantation has undergone dramatic technologic improvements, yielding highly promising results. This review presents an outline on the ongoing evolution of transcatheter aortic valve implantation in an attempt to provide insight into its future use in the clinical management of severe aortic stenosis.
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