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Volume 14
Issue 16
10.3390/jcm14165651
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve–Interpreting Current Evidence for Personalized Valve Selection

by
Panayotis K. Vlachakis
1,*,
Panagiotis Theofilis
1,
Ioannis Kachrimanidis
1,
Stergios Soulaidopoulos
1,
Anastasios Apostolos
1,
Ioannis Skalidis
2,
Paschalis Karakasis
3,
Nikolaos Ktenopoulos
1,
Maria Drakopoulou
1,
Andreas Synetos
1,
Costas Tsioufis
1 and
Konstantinos Toutouzas
1
1
1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
2
Institut Cardiovasculaire Paris-Sud, Hôpital Jacques Cartier, Ramsay-Santé, 91300 Massy, France
3
Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(16), 5651; https://doi.org/10.3390/jcm14165651 (registering DOI)
Submission received: 12 April 2025 / Revised: 29 July 2025 / Accepted: 8 August 2025 / Published: 9 August 2025
(This article belongs to the Section Cardiology)
Versions Notes

Abstract

Transcatheter aortic valve implantation (TAVI) has transformed the treatment of aortic valve stenosis, offering a less invasive alternative to surgical valve replacement, particularly in elderly and high-risk populations. As TAVI expands into younger, lower-risk patients, the choice of transcatheter heart valve has become increasingly important to optimize both immediate and long-term outcomes. Currently, Self-Expandable Valves (SEVs) and Balloon-Expandable Valves (BEVs) are the two most widely used platforms, each characterized by distinct design features, implantation techniques, and hemodynamic profiles. While no definitive evidence supports the overall superiority of one valve type over the other, accumulating clinical data highlight specific advantages and limitations depending on anatomical and procedural contexts. This review aims to present and critically discuss the current evidence, clinical considerations, and evolving concerns surrounding the use of SEVs versus BEVs, with a particular focus on challenging scenarios such as valve-in-valve procedures and long-term valve strategy planning.
Keywords: aortic stenosis; TAVI; balloon-expandable valve; self-expandable valve; valve-in-valve; structural heart diseases; interventional cardiology aortic stenosis; TAVI; balloon-expandable valve; self-expandable valve; valve-in-valve; structural heart diseases; interventional cardiology

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MDPI and ACS Style

Vlachakis, P.K.; Theofilis, P.; Kachrimanidis, I.; Soulaidopoulos, S.; Apostolos, A.; Skalidis, I.; Karakasis, P.; Ktenopoulos, N.; Drakopoulou, M.; Synetos, A.; et al. The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve–Interpreting Current Evidence for Personalized Valve Selection. J. Clin. Med. 2025, 14, 5651. https://doi.org/10.3390/jcm14165651

AMA Style

Vlachakis PK, Theofilis P, Kachrimanidis I, Soulaidopoulos S, Apostolos A, Skalidis I, Karakasis P, Ktenopoulos N, Drakopoulou M, Synetos A, et al. The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve–Interpreting Current Evidence for Personalized Valve Selection. Journal of Clinical Medicine. 2025; 14(16):5651. https://doi.org/10.3390/jcm14165651

Chicago/Turabian Style

Vlachakis, Panayotis K., Panagiotis Theofilis, Ioannis Kachrimanidis, Stergios Soulaidopoulos, Anastasios Apostolos, Ioannis Skalidis, Paschalis Karakasis, Nikolaos Ktenopoulos, Maria Drakopoulou, Andreas Synetos, and et al. 2025. "The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve–Interpreting Current Evidence for Personalized Valve Selection" Journal of Clinical Medicine 14, no. 16: 5651. https://doi.org/10.3390/jcm14165651

APA Style

Vlachakis, P. K., Theofilis, P., Kachrimanidis, I., Soulaidopoulos, S., Apostolos, A., Skalidis, I., Karakasis, P., Ktenopoulos, N., Drakopoulou, M., Synetos, A., Tsioufis, C., & Toutouzas, K. (2025). The TAVI Dilemma: Balloon-Expandable or Self-Expanding Transcatheter Heart Valve–Interpreting Current Evidence for Personalized Valve Selection. Journal of Clinical Medicine, 14(16), 5651. https://doi.org/10.3390/jcm14165651

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