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Percutaneous aortic valve replacement , also known as percutaneous aortic valve implantation , transcatheter aortic valve implantation or transcatheter aortic valve replacement , is the replacement of the aortic valve of the heart through the blood vessels. The replacement valve is delivered via one of several access methods: transfemoral , transapical , subclavian , direct aortic , and transcaval , among others.
Severe symptomatic aortic stenosis carries a poor prognosis. At present there is no treatment via medication, making the timing of aortic valve replacement the most important decision to make for these patients. Until recently, surgical aortic valve replacement was the standard treatment for adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure or coronary artery disease, as well as in people with comorbidities such as cerebrovascular and peripheral arterial disease, chronic kidney disease, and chronic respiratory dysfunction.