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Aortic Valve Implantation: Recent Advances and Future Prospects
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Aortic Valve Implantation: Recent Advances and Future Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 November 2025) | Viewed by 4546

Special Issue Editors

Dr. Suvitesh Luthra

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Guest Editor
Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton SO16 6YD, UK
Interests: aortic valve replacement; aortic stenosis; paravalvular leak
Dr. Richard Jabbour

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Guest Editor
Wessex Cardiothoracic Centre, University Hospital Southampton, Southampton SO16 6YD, UK
Interests: coronary and structural interventional cardiology; percutaneous coronary artery interventions; aortic valve implantation

Special Issue Information

Dear Colleagues,

Aortic disease is the most common valvular heart disease. Aortic valve implantation has become a therapy for patients with low- and intermediate-risk severe aortic stenosis. The wide range of diseases that can be treated using aortic valve implantation include insufficiency, subvalvular stenosis, endocarditis, and bicuspid degeneration.

Aortic valve diseases have experienced a revolution in the past decade with the introduction of valve implantation therapies providing a mini-invasive, safe, and efficient treatment for the majority of patients. Due to the increasing rate of valve implantation use, data on outcomes and variables impacting outcomes continue to be of interest. Recently research has focused on permanent pacemaker implantation rates, cases where the valve has become narrowed (aortic stenosis) or the valve is leaky (aortic regurgitation), aortic valve-in-valve procedures, and a new generation of trans-catheter heart valve devices.

This Special Issue aims to collect original articles, reviews, and other contributions on the current state and future developments of aortic valve implantation, focused on these and other related topics, aiming at bringing the reader up to date with the advances in aortic valve implantation.

Dr. Suvitesh Luthra
Dr. Richard Jabbour
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic valve replacement
  • aortic stenosis
  • paravalvular leak
  • coronary and structural interventional cardiology
  • percutaneous coronary artery interventions

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Published Papers (4 papers)

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Research

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16 pages, 272 KB  
Article
Validation of the VALVEX Questionnaire for Assessing Patient Experience During the Transcatheter Aortic Valve Implantation Process
by Miryam González-Cebrian, Elena Calvo, Sara Alonso Meléndez, Héctor Gómez García, Francisco Javier Rubio Gil, Ignacio Cruz-González, Pedro L. Sánchez, Luis Miguel Rincón and José Luis Mendoza-García
J. Clin. Med. 2025, 14(23), 8562; https://doi.org/10.3390/jcm14238562 - 2 Dec 2025
Viewed by 217
Abstract
Background and Objectives: Degenerative aortic stenosis has become the most common primary valve lesion referred for intervention, with thousands of transcatheter aortic valve implantation (TAVI) procedures being performed annually. To date, there are no quantitative tools capable of evaluating patient experience adapted to [...] Read more.
Background and Objectives: Degenerative aortic stenosis has become the most common primary valve lesion referred for intervention, with thousands of transcatheter aortic valve implantation (TAVI) procedures being performed annually. To date, there are no quantitative tools capable of evaluating patient experience adapted to percutaneous procedures of this nature. The goal of this study is to propose and validate the VALVEX questionnaire as the reference tool to assess patient experience throughout the TAVI process and to identify areas for improvement in healthcare. Methods: This was a cross-sectional observational study with a 30-day follow-up that included consecutive patients > 18 years of age undergoing elective TAVI in two Spanish hospitals. A multidisciplinary panel including patients was constituted to design, refine, and pilot the VALVEX questionnaire. During its completion 30 days after the procedure, the dimensions assessed were the care provided before, during, and after TAVI, as well as the facilities and overall patient satisfaction. Reliability, validity, and feasibility were analysed during the validation phase. Results: A total of 335 patients were enrolled and filled out the VALVEX questionnaire (mean age 81.1 ± 5 years, 52% female). Evaluation of feasibility showed a mean completion time of 7.8 ± 2.3 min, with a 2.1% rate of unanswered questions. Cronbach’s alpha index was 0.912, with high internal reliability measurements for all the assessed dimensions. An intraclass correlation coefficient (ICC) of 0.851 was determined as an indicator of stability. The Delphi panel achieved a consensus of over 85% in clarity, coherence, relevance, and sufficiency. Conclusions: We have successfully validated the VALVEX questionnaire as the first quantitative tool specifically designed to measure and evaluate patient experience throughout the TAVI procedure and recovery. This questionnaire is a valid, reliable, simple, and easy-to-use resource that could be used as a reference tool to assess patient experience for TAVI or other percutaneous cardiac interventions. Full article
(This article belongs to the Special Issue Aortic Valve Implantation: Recent Advances and Future Prospects)
7 pages, 4029 KB  
Communication
Minimizing Permanent Pacemaker Implantation After TAVR: Current Strategies, Monitoring Pathways, and Future Directions
by Alfonso Reyes Mitre, Hector Lopez de la Garza, Claudio Espada Guerreiro, Dahyr Olivas Medina, Erick Marlon Avila Gil, Pablo Juan Salvadores, José Antonio Baz Alonso, Andres Iñiguez Romo and Victor Alfonso Jimenez Diaz
J. Clin. Med. 2025, 14(21), 7700; https://doi.org/10.3390/jcm14217700 - 30 Oct 2025
Viewed by 686
Abstract
Transcatheter aortic valve replacement (TAVR) has evolved over the last two decades into a cornerstone therapy for patients with severe symptomatic aortic stenosis. This therapy was initially reserved for those at high or prohibitive surgical risk but is now firmly established across all [...] Read more.
Transcatheter aortic valve replacement (TAVR) has evolved over the last two decades into a cornerstone therapy for patients with severe symptomatic aortic stenosis. This therapy was initially reserved for those at high or prohibitive surgical risk but is now firmly established across all surgical risk categories. Its non-inferiority to surgical aortic valve replacement has been demonstrated even in low-risk populations, supporting the rapid worldwide expansion of its use. Nevertheless, despite procedural refinements and the advent of newer-generation prostheses, conduction disturbances leading to permanent pacemaker implantation (PPI) remain one of the most frequent and clinically relevant complications. Reported incidence ranges between 8% and 20% depending on prosthesis type, implantation technique, and baseline patient characteristics. Multiple clinical, anatomical, and procedural factors have been identified as strong predictors of post-TAVR conduction disturbances. Taken together, the integration of anatomical and clinical risk assessment, precise procedural planning, careful device selection, structured monitoring, and emerging therapeutic strategies constitutes a comprehensive, evidence-based approach to reduce the burden of conduction disturbances following TAVR. Such a multimodal framework has the potential not only to lower the incidence of permanent pacemaker implantation but also to improve safety, optimize healthcare resource utilization, and support the broader adoption of TAVR in increasingly younger and lower-risk patient populations. Full article
(This article belongs to the Special Issue Aortic Valve Implantation: Recent Advances and Future Prospects)
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Review

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17 pages, 2459 KB  
Review
Definition, Incidence, Prediction, and Prevention of Bleeding Events After Transcatheter Aortic Valve Implantation
by Iosif Xenogiannis, Ioannis Lianos, Grigoris V. Karamasis, Charalampos Varlamos, Fotios Kolokathis, Christos Pappas, Stamatia Kovra, Konstantinos Tsaousidis, Christos Mourmouris, Antonis N. Pavlidis, Andreas S. Triantafyllis and Andreas S. Kalogeropoulos
J. Clin. Med. 2025, 14(20), 7154; https://doi.org/10.3390/jcm14207154 - 10 Oct 2025
Viewed by 1540
Abstract
Bleeding remains the most common complication following transcatheter aortic valve implantation (TAVI), despite a decline in its incidence over time. Periprocedural (≤30 days) major or life-threatening bleeding is reported to occur in 2.0–6.6% of patients undergoing TAVI. Major bleeding events carry a significant [...] Read more.
Bleeding remains the most common complication following transcatheter aortic valve implantation (TAVI), despite a decline in its incidence over time. Periprocedural (≤30 days) major or life-threatening bleeding is reported to occur in 2.0–6.6% of patients undergoing TAVI. Major bleeding events carry a significant risk of mortality, with rates of 14.1% at 30 days and 27.8% at one year. The timely identification and management of patients at an elevated risk are therefore essential. Preventive measures include optimizing antithrombotic therapies, utilizing ultrasound-guided femoral access, employing single arterial access or a radial artery for secondary access, and administering unfractionated heparin under close monitoring. Long-term follow-up is essential for recognizing and managing late hemorrhages. In this review, we aimed to provide an in-depth analysis of bleeding events associated with TAVI and the most recent updates regarding the antithrombotic therapy of TAVI patients and its clinical impact. Full article
(This article belongs to the Special Issue Aortic Valve Implantation: Recent Advances and Future Prospects)
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26 pages, 2260 KB  
Review
Transcatheter Aortic Valve Implantation in Cardiogenic Shock: Current Evidence, Clinical Challenges, and Future Directions
by Grigoris V. Karamasis, Christos Kourek, Dimitrios Alexopoulos and John Parissis
J. Clin. Med. 2025, 14(15), 5398; https://doi.org/10.3390/jcm14155398 - 31 Jul 2025
Cited by 1 | Viewed by 1450
Abstract
Cardiogenic shock (CS) in the setting of severe aortic stenosis (AS) presents a critical and high-risk scenario with limited therapeutic options and poor prognosis. Transcatheter aortic valve implantation (TAVI), initially reserved for inoperable or high-risk surgical candidates, is increasingly being considered in patients [...] Read more.
Cardiogenic shock (CS) in the setting of severe aortic stenosis (AS) presents a critical and high-risk scenario with limited therapeutic options and poor prognosis. Transcatheter aortic valve implantation (TAVI), initially reserved for inoperable or high-risk surgical candidates, is increasingly being considered in patients with CS due to improvements in device technology, operator experience, and supportive care. This review synthesizes current evidence from large registries, observational studies, and meta-analyses that support the feasibility, safety, and potential survival benefit of urgent or emergent TAVI in selected CS patients. Procedural success is high, and early intervention appears to confer improved short-term and mid-term outcomes compared to balloon aortic valvuloplasty or medical therapy alone. Critical factors influencing prognosis include lactate levels, left ventricular ejection fraction, renal function, and timing of intervention. The absence of formal guidelines, logistical constraints, and ethical concerns complicate decision-making in this unstable population. A multidisciplinary Heart Team/Shock Team approach is essential to identify appropriate candidates, manage procedural risk, and guide post-intervention care. Further studies and the development of TAVI-specific risk models in CS are anticipated to refine patient selection and therapeutic strategies. TAVI may represent a transformative option for stabilizing hemodynamics and improving outcomes in this otherwise high-mortality group. Full article
(This article belongs to the Special Issue Aortic Valve Implantation: Recent Advances and Future Prospects)
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