Current Models of Transcatheter Aortic Valves: Comparative Analysis of Design, Clinical Outcomes and Development Prospects

Systematic reviews and original research articles should have a structured abstract of Background/Objectives: Transcatheter aortic valve implantation (TAVI) has become the standard of care for severe aortic stenosis across all surgical risk categories. Continuous innovation in prosthesis technology necessitates a comprehensive analysis of contemporary TAVI systems to guide device selection and understand evolving trends. The aim of this review is to synthesize the latest evidence (2023–2025) on the design, clinical performance, and future directions of current TAVI models. Methods: We conducted a detailed review of current TAVI models from leading manufacturers (Medtronic, Abbott, Boston Scientific, Biotronik, etc.), examining their technical specifications, design innovations, and data from recent international clinical trials and registries. A comparative analysis was performed based on key parameters: delivery profile, resheathability/repositionability, sealing mechanisms, hemodynamic performance, and complication rates. Results: Modern TAVI prostheses demonstrate significant advancements. Self-expanding nitinol frames offer superior adaptability and lower profiles (as low as 14 Fr). Innovations in sealing technology have drastically reduced the incidence of moderate-to-severe paravalvular leak (PVL) to below 2–3%. Supra-annular leaflet designs provide superior hemodynamics. Clinical outcomes show excellent 30-day mortality rates (1.1–2.0%) and durability estimates of 10–15 years. Variation exists between devices in rates of permanent pacemaker implantation and coronary access. Conclusions: The current generation of TAVI prostheses represents a mature technology offering high safety and efficacy. The key development vectors are focused on further device miniaturization, enhancing long-term durability, and expanding indications. The choice of a specific prosthesis should be individualized based on patient anatomy and clinical characteristics.