Are the standard criteria for TAVI too lax or too strict?

Among the elderly, however, up to 30-40% of cases are considered too high risk or inappropriate for conventional open heart surgery and hence remain unreferred and untreated. 1 2 Transcatheter aortic valve implantation (TAVI-term coined at the joint ESC/EACTS consensus meeting in 2008 as best describing the procedure which involves valve implantation rather than replacement), offers considerable promise in treating these high-risk patients. 3 TAVI has become a rapidly evolving technique with potential to create a paradigm shift similar to the introduction of percutaneous transluminal coronary angioplasty (PTCA) in the early 1980s. First and foremost, adherence to clinical criteria should involve an emphasis on MDT assessment, taking into account patient risk factors, local results of AVR across the age groups, accessibility of patient vasculature and the patient's overall survival prospects (and frailty).