Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, particularly in patients at high risk of adverse events for traditional open-heart surgery. Since the early 2000s, TAVR has evolved rapidly with advancements in device technology, procedural techniques, and patient selection criteria. Over the past 20 years, this catheter-based procedure has significantly improved patient survival and quality of life, demonstrating both the safety and efficacy of TAVR, even in patients at low surgical risk. This paper reviews the latest advances in valve design and strategies for treating aortic stenosis. It explores the challenges with long-term outcomes given the younger age of patients undergoing TAVR and the prospects of emerging technologies to improve long-term outcomes.

The left atrial appendage occlusion (LAAO) procedure is an important intervention for stroke prevention in patients with non-valvular atrial fibrillation who cannot tolerate anticoagulation. Accurate imaging is essential to guide and ensure optimal device deployment. Transesophageal echocardiography (TEE) has traditionally been the gold standard for procedural guidance, but intracardiac echocardiography (ICE) is emerging as an alternative owing to its unique advantages. This review examines the comparative effectiveness, procedural advantages, limitations, and clinical outcomes of ICE and TEE in LAAO closure, highlighting emerging trends and implications for future clinical practice.

Tricuspid regurgitation (TR) is common, undertreated, and associated with substantial morbidity and mortality. Transcatheter tricuspid valve intervention (TTVI), comprising transcatheter edge-to-edge repair (TEER) and transcatheter tricuspid valve replacement (TTVR), has emerged as an alternative to surgery. In this narrative review, we summarize device design and implantation techniques (TriClip, PASCAL, Cardioband, EVOQUE), evidence from pivotal and early feasibility trials (TRILUMINATE, CLASP TR, TRI-REPAIR, TRISCEND II), and the anatomic and clinical factors that guide patient selection. TEER and annuloplasty reduce TR and improve symptoms and quality of life, with lower rates of bleeding and conduction disturbance than TTVR. TTVR with EVOQUE achieved more complete TR reduction (99.1% with moderate or less TR) but carried higher rates of bleeding and new pacemaker implantation. Differences in trial design and study populations preclude direct comparison. Coaptation gap, jet location, leaflet tethering, annular size, device leads, and right ventricular function determine device suitability. TTVI is an effective treatment for TR, but long-term durability and conduction-system safety remain uncertain. We propose a heart team algorithm to guide selection between TEER and TTVR.