Transcatheter aortic valve replacement (TAVR) is the implantation of the aortic valve of the heart through the blood vessels without actual removal of the native valve (as opposed to the aortic valve replacement by open heart surgery, surgical aortic valve replacement, AVR). The first TAVI was performed on 16 April 2002 by Alain Cribier, which became a new alternative in the management of high-risk patients with severe aortic stenosis. The implantated valve is delivered via one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone), direct aortic (through a minimally invasive surgical incision into the aorta), and transcaval (from a temporary hole in the aorta near the navel through a vein in the upper leg), among others.

Severe symptomatic aortic stenosis carries a poor prognosis. At present, there is no treatment via medication, making the timing of aortic valve replacement the most important decision to make for these patients. Until recently, surgical aortic valve replacement was the standard treatment for adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure or coronary artery disease, as well as in people with comorbidities such as cerebrovascular and peripheral arterial disease, chronic kidney disease, and chronic respiratory dysfunction.

Patients with symptomatic severe aortic stenosis have a mortality rate of approximately 50% at 2 years without intervention. In patients who are deemed too high risk for open heart surgery, TAVI significantly reduces the rates of death and cardiac symptoms. Until about 2017 TAVI was not routinely recommended for low-risk patients in favor of aortic valve replacement, however it is increasingly being offered to intermediate risk patients, based on studies finding that it is not inferior to surgical aortic valve replacement.

Transapical TAVI is reserved for patients for whom other approaches are not feasible: an evidence-based BMJ Rapid Recommendation made a strong recommendation against transapical TAVI in people who are also candidates for either transfemoral TAVI or surgery. People who have the option of either transfemoral TAVI or surgical replacement are likely to choose surgery if they are younger than 75 and transfemoral TAVI if they are older than 75. The rationale for age-based recommendations is that surgical aortic valve replacements are known to be durable long-term (average of durability of 20 years), so people with longer life expectancy would be at higher risk if TAVI durability is worse than surgery.

Medtronic's CoreValve Transcatheter Aortic Valve is constructed of a self-expanding Nitinol (nickel titanium) frame and delivered through the femoral artery. This device received FDA approval in January 2014.

Boston Scientific's Lotus Valve system was awarded CE mark approval in October 2013. It allows the final position to be assessed and evaluated before release and has been designed to minimise regurgitation. Boston Scientific has since retired the device as of January 11, 2021. This was primarily due to difficulty regarding the ability to reposition and recapture the valve.

St Jude Medical's Portico Transcatheter aortic valve received European CE mark approval in December 2013. The valve is repositionable before release to ensure accurate placement helping to improve patient outcomes.

Edwards' Sapien aortic valve is made from bovine pericardial tissue and is implanted via a catheter-based delivery system. It is approved by the FDA for use in the US.