Pre-hospital patient selection for transcatheter aortic valve implantation
General Medicine, 2025, 27(5), 40-47.
R. Pencheva1, B. Barzashka1, I. Dimitrova1, D. Trendafilova1, V. Kolev2
1Clinic of Cardiology, Department of Cardiovascular Surgery and Invasive Cardiology, University Hospital “Sv. Ekaterina”, MU – Sofia
2Department of Propedeutics of Internal Diseases, UMHAT “Alexandrovska”, Medical Faculty, Medical University – Sofia
Abstract. Transcatheter Aortic Valve Implantation (TAVI) has been established as a standard therapeutic option for patients with severe aortic stenosis and elevated surgical risk. With the expansion of indications toward lower-risk populations, the importance of timely identification and selection of appropriate patients in the outpatient setting continues to grow. Advancements in next-generation valve technology have enabled the application of TAVI in patients with high grade pure Non-Calcified Aortic Regurgitation (PNAR), i.e., without calcification, without a stenotic component, and without a prior valve prosthesis, thereby broadening the therapeutic indications. This review examines the role of outpatient specialists in recognizing indications for TAVI, the referral algorithm toward a multidisciplinary team, and the essential imaging and laboratory assessments involved in the preprocedural evaluation. Key clinical factors influencing the decision between TAVI and Surgical Aortic Valve Replacement (SAVR) are also discussed in the context of long-term disease management.
Key words: aortic stenosis, transcatheter aortic valve implantation, outpatient evaluation, patient selection, computed tomography
Address for correspondence: Radostina Pencheva, MD, e-mail: r.h.pencheva@gmail.com