{"doi":"10.1016/j.xjon.2020.07.001","title":"Commentary: Rainmaking the “next-generation transcatheter aortic valve implantation” by anointing multidisciplinary perceptions","abstract":"Central MessageA multidisciplinary approach of decellularization, immunologically modified α-galactosidase, and 3D-printing technology improves the performance of next-gen TAVI.See Article page 14. A multidisciplinary approach of decellularization, immunologically modified α-galactosidase, and 3D-printing technology improves the performance of next-gen TAVI. See Article page 14. Transcatheter aortic valve implantation (TAVI) has been the standard management strategy for aortic stenosis (AS) owing to its durability and fidelity, even in the patients with greater procedural risk.1Cahill T.J. Chen M. Hayashida K. Latib A. Modine T. Piazza N. et al.Transcatheter aortic valve implantation: current status and future perspectives.Eur Heart J. 2018; 39: 2625-2634Crossref PubMed Scopus (107) Google Scholar Introduced in 2002 by Cribier and colleagues,2Cribier A. Eltchaninoff H. Bash A. Borenstein N. Tron C. Bauer F. et al.Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis.Circulation. 2002; 106: 3006-3008Crossref PubMed Scopus (2561) Google Scholar TAVI has revolutionized the care of patients with AS, as evident by drastic increase with success stories of the patients (>300,000 annually) who have undergone TAVI procedure. However, the risk of complications including stroke, concomitant coronary artery diseases, and postoperative lifelong antithrombotic therapeutic regimen offer serious challenges in TAVI-based management strategies.3Ali N. Patel P.A. Lindsay S.J. Recent developments and controversies in transcatheter aortic valve implantation.Eur J Heart Fail. 2018; 20: 642-650Crossref Scopus (8) Google Scholar Even though the outcomes of TAVI are encouraging, the information regarding the fate of TAVI beyond 5 years remains obscure.4Arsalan M. Walther T. Durability of prostheses for transcatheter aortic valve implantation.Nat Rev Cardiol. 2016; 13: 360-367Crossref PubMed Scopus (110) Google Scholar Interestingly, these hurdles are not a limiting factor for TAVI; however, they pave multiple ways for refining the technology to explore alternative modalities for treating the patients with impaired vascular anatomy. In fact, the present-generation TAVI is the fruit of a progressive evolution, especially in the simplification of procedures, sophistication of valve and catheter technologies, incorporation of preprocedural planning using computed tomography imaging, and automation, ensuring the capability to predict the potential complications.1Cahill T.J. Chen M. Hayashida K. Latib A. Modine T. Piazza N. et al.Transcatheter aortic valve implantation: current status and future perspectives.Eur Heart J. 2018; 39: 2625-2634Crossref PubMed Scopus (107) Google Scholar As the TAVI research continues, novel concepts, modifications, and inventions are emerging and proceeding towards perfection. Application of the mechanical valve is limited, owing to the potential risk of bleeding due to the lifelong prophylactic anticoagulant medication administered to minimize thrombus formation. In contrast, the in vivo structural alterations in the biological valve increase the likelihood of reoperation. Interestingly, the advent of xenograft valves from porcine, bovine, and equine origins has significantly improved the hemodynamic profile, durability, and biological performance of TAVI.5Cohen G. Christakis G.T. Joyner C.D. Morgan C.D. Tamariz M. Hanayama N. et al.Are stentless valves hemodynamically superior to stented valves? A prospective randomized trial.Ann Thorac Surg. 2002; 73: 767-778Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar However, the immunogenicity of transplanted xeno-valves and subsequent peril of calcification have been an unaddressed puzzle in clinical cardiology and transplantation medicine. For instance, antigenicity of the carbohydrate moiety, galactose-α1,3-galactose (α-Gal), results in hyperacute immune rejection of the porcine xenograft as well as intensive calcifica","journal":"JTCVS Open","year":2020,"id":130356,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9598,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":363510,"name":"Finosh G. Thankam","orcid":"0000-0001-7285-9808","position":1,"is_corresponding":false},{"id":363513,"name":"Devendra K. Agrawal","orcid":"0000-0001-5445-0013","position":0,"is_corresponding":true}],"reference_count":8,"raw_metadata":null,"created_at":"2026-07-18T23:15:53.196774Z","pmid":"36003858","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}