Transcatheter Aortic Valve Replacement (TAVR) has revolutionised the treatment of severe aortic stenosis, offering a minimally invasive alternative to surgical valve replacement for high-, intermediate- and even selected low-risk patients. As evidence rapidly evolves, clinicians and interventional specialists consistently seek updates on TAVR when exploring advanced procedural topics at a cardiology conference. With expanding device options, refined imaging techniques and improved long-term outcomes, TAVR continues to transform the broader landscape of structural heart interventions.

The session begins by examining the clinical burden of aortic stenosis and the evolution of transcatheter therapy from high-risk indications to broader eligibility. Participants learn how patient-selection criteria incorporate surgical risk, frailty assessment, anatomical suitability and shared decision-making. Comparisons between TAVR and surgical AVR highlight the shifting paradigm in modern valve care, with increasing adoption supported by robust trial evidence.

Technical aspects are discussed in depth. Attendees review valve types, delivery systems, access routes (transfemoral, transapical and alternative access), annular sizing and pre-procedural planning using CT imaging. Procedural steps including vascular access, valve positioning, rapid pacing, deployment and post-deployment optimisation are explored with practical insights from contemporary cases. Strategies to manage challenges such as calcification, tortuous vasculature and annular anatomy are thoroughly covered.

Attention is given to potential complications, including paravalvular leak, conduction disturbances, vascular injury, coronary obstruction and stroke. The session explains methods for prevention, early detection and multidisciplinary management, including pacing strategies, embolic-protection devices and vascular-closure innovations.

Long-term considerations include durability assessments, valve-in-valve procedures, antithrombotic therapy and post-procedural follow-up. Participants also explore TAVR in bicuspid aortic valves, younger patients and those with complex root anatomy. Real-world data and registry findings are reviewed to offer broader context on global utilisation trends.

Future directions involve next-generation valves that improve sealing, reduce conduction disturbances and enhance durability, as well as fusion imaging, robotics and AI-assisted procedural planning. The session equips clinicians with an updated, evidence-based framework for delivering safe, effective and personalised TAVR care.