Table 1.

Currently accepted clinical indications to TAVI summarised from the ESC/EACTS and AHA/ACC guidelines and from recently updated ACC/AHA expert consensus decision pathway [7, 9]

	ACC/AHA*	ESC/EACTS^
Approach to care and clinical decision-making:	To be established by a shared decision of local heart team	To be made by a “heart team” with specific expertise in VHD
Indications to the procedure:	Recommended in patients with indication to intervention for AS combined with a prohibitive surgical risk and a predicted post-procedural survival > 12 months	Indicated in patients with severe AS and contraindication to surgery, with an estimated life expectancy > 1 year and an expected improvement of QoL by TAVI
General contraindications:	Overall procedural risks and contraindications based on scores evaluating patient’s frailty and disability plus cognitive and physical function	General absolute contraindications include the absence of a local “heart team” and/or an on-site cardiac surgery facility
Importance of comorbidities:	Procedure considered futile if life expectancy < 1 year and/or survival with benefit < 25% at 2 years (i.e. lack of improvement in NYHA or CCS functional classes, quality of life or life expectancy)	Contraindicated In presence of extra-aortic valvular disease that can be treated only by surgery and/or in presence of an estimated life expectancy < 1 year and/or unlikely post-procedural improvement of QoL
Anatomic contraindications:	Non-specified (considered part of the clinical decision-making process performed by local heart team)	Inadequate annulus sizing (i.e. < 18 mm and a 29 mm) Intracavitary thrombus, endocarditis, risk of coronary ostium obstruction and ascending aorta/arch unstable atheromasia Inadequate vascular access

*ACC/AHA: American College of Cardiology/American Heart Association

^ESC/EACTS: European Society of Cardiology/European Association of Cardio-Thoracic Surgery