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

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 and clinically oriented analysis of contemporary TAVI systems to guide device selection and understand evolving trends. This review aims to provide a practical, device-specific decision-making framework for TAVI prosthesis selection, synthesizing the latest evidence (2023–2025) to address the challenge of individualized choice in an era of device proliferation. 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. 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. 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. This analysis provides a novel, clinically oriented comparison that moves beyond technical specifications to guide optimal device selection based on specific patient anatomy and clinical characteristics.