Simplify TAVI

As the majority of the TAVI protocols and techniques were ‘inherited’ from the combination of surgical treatment of aortic valve stenosis and percutaneous treatment of coronary artery disease, initial protocols surrounding TAVI were quite extensive. As the development of TAVI proceeds, scientific knowledge expands and incredible amounts of experience are gained, all components of TAVI will be refined, and presumably simplified. The screening, procedure, prostheses and the post procedural care will evolve into the least invasive strategy possible, while retaining optimal patient treatment outcomes, and simultaneously enlarging the treated population. This thesis covers several aspects of TAVI, starting with the evolution of TAVI in the Netherlands. Several adjustments to the TAVI strategy have been proposed to further simplify and streamline TAVI. We discuss the use of CTCA as a gatekeeper in the screening process, the use of coronary physiology to decide whether or not to treat concomitant coronary artery disease and introduce new adjustments to the protocols, starting with the use of cerebral protection, the performance of Transfemoral (TF-) TAVI without the support of anaesthesiologists, early ambulation after TF-TAVI and the use of novel MRI techniques to assess treatment outcome.