Evolution of technology in replacement of heart valves: Transcatheter aortic valves, a revolution for management of valvular heart diseases

Objectives: The goal of this study is to analyze the evolution of technology in artificial heart valves for solving the problem of aortic stenosis (a narrowing of the aortic valve opening) that is one of the most common valvular heart diseases in society. In particular, this study explains the evolution of new technology of transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR). Methods: Data of Scopus (2020) based scientific products and patents that have in title, abstract or keywords the following terms: "transcatheter aortic valve implantation (TAVI)" or "surgical aortic valve replacement (SAVR)". The evolution of technology is analyzed with a model, which shows how TAVI technique is substituting established technique of SAVR in cardiology. The relationships are investigated with loglinear models using ordinary least squares method for estimating the unknown parameters. Statistical analyses are performed with the Statistics Software SPSS (R) 26. Results: Statistical analyses reveal that TAVI, with its growing scientific and technological production, is expected to be a dominant technology in future for the treatment of aortic stenosis in society. In fact, the scientific production of TAVI has a coefficient of growth in function of time equal to 0.39(P<.001) compared to a coefficient for SAVR that is 0.10(P<.001). Statistical analyses with patent production confirm these results. Findings hint at general properties of the evolutionary behavior of this medical technology: 1) TAVI has a disproportionate growth in scientific products and patents compared to SAVR; 2) TAVI has a growing scientific and technological production driven by major and minor technological advances to solve consequential problems to treat valvular heart diseases; 3) learning via diffusion and diffusion by learning are driving forces underlying the development and adoption of TAVI in cardiology. Conclusions: TAVI, introduced in 2002, is growing in terms of scientific production and innovative activity to revolutionize the management of aortic stenosis in cardiology with important implications of health management based on improved cost-effectiveness of this new technology and better efficiency in healthcare of people.