Debate: Minimalist approach to TAVI as a default strategy

QUESTION: For starters, what is the minimalist approach to transcatether aortic valve implantation (TAVI)? ANSWER: After the first case described by Cribier et al.1 back in 2002, the management of aortic stenosis through TAVI has consolidated and become a safe and effective therapy that is based on a well-established and standardized procedure. Although it is a complex procedure due to the characteristics of patients and devices and the fact that experienced operators are needed, the growing number of cases reported, and the technological advances made with the devices have improved processes and reduced complications significantly. This has prompted that, over the last few years, certain experienced groups2 have modified certain steps of the procedure and introduced strategies before and after the intervention to simplify and make TAVI more efficient. Also, to promote faster recoveries in the patients. This set of modifications is described as minimalist approach to TAVI. Two of the most significant aspects here are suppressing balloon dilatation and reducing hospital stays. However, there are simplifying strategies that can be divided into 3 parts: previous assessment and case analysis, valve implantation, and postoperative care. During the previous assessment part, the objective is to speed up the study circuits of the...