Aortic stenosis lesions are the most common heart valve disease in the elderly, with pathological changes presenting as chronic inflammation and valve calcification. Most patients are usually asymptomatic in the early stages of the disease, and those with this disease have an annual mortality rate of 50%! Successful percutaneous aortic valve replacement can reduce the one-year mortality rate from 50% to 30% in the elderly The probability of degenerative heart valve disease has increased with the aging of the population. Aortic stenosis lesions are the most common form of heart valve disease in the elderly. The pathological changes present as chronic inflammation with valvular calcification. It is estimated that approximately 2% of older adults over 65 years of age have this disease; up to 4% of those over 85 years of age. Most patients are usually asymptomatic in the early stages of the disease, and as the degree of valve stenosis increases, the patient will gradually present with shortness of breath after exercise, dyspnea, angina, and even fainting. Patients do not realize that these symptoms are due to heart valve disease, but believe that it is due to age, so they simply reduce their activity without seeking medical attention. Unbeknownst to them, people suffering from this disease have an annual mortality rate of 50%! What a shocker! The traditional treatment for geriatric aortic stenosis is surgical valve replacement, which requires a median chest incision, supported by extracorporeal circulation, with the heart in arrest. The surgical mortality rate is less than 1% when operated by a surgeon with extensive experience. Unfortunately, not all patients with aortic stenosis are able to tolerate surgery. Patients who are very old and have poor systemic status such as chronic lung disease, renal failure, anemia, and tumors cannot undergo surgery. In addition, surgery is after all an open-heart operation, which is highly traumatic, with a lot of bleeding and a long recovery period, and the risk of perioperative stroke cannot be ignored. Transcatheter Aortic Valve Implantation (TAVI) is a new field and breakthrough in recent years in interventional cardiology research and treatment. Since the first patient underwent percutaneous aortic valve replacement in 2002, more than 10,000 patients have benefited worldwide. The procedure can be performed in two ways: first, by puncturing the femoral artery (root of the thigh) to deliver the prosthetic valve to the original valve location and then expanding it to replace the original valve for normal function. The second is to make a small incision through the chest and implant the prosthetic valve directly through the patient’s apical (transapical) heart. The latter is a higher risk procedure with a lower success rate. Currently, percutaneous aortic valve replacement is not the preferred treatment for aortic stenosis because its clinical application is still short and therefore not very mature. However, percutaneous aortic valve replacement is indeed an effective therapeutic option in high-risk patients who are not suitable for surgical procedures (e.g., very advanced age, chronic lung disease, renal failure, anemia, and tumors as mentioned earlier), and its availability is undoubtedly a boon for such patients. Clinical studies have shown that successful percutaneous aortic valve replacement can reduce the one-year mortality rate from 50% to 30%. Ten successful cases have been performed at the NUH Cardiac Center The success rate of percutaneous aortic valve replacement is very high on a purely technical basis. In the right patient, the procedure rarely fails. The key to the success of percutaneous aortic valve replacement is the need for a group of formally trained and well-trained medical teams, including interventional cardiologists, cardiac surgeons, anesthesiologists, cardiac ultrasound physicians, nurses, technicians, and more than 10 others to perform the procedure. The NUH Heart Center has successfully performed more than 10 cases of percutaneous aortic valve replacement since its inception in 2010. This clinical service relies on the cooperation and close collaboration of the team members. The introduction of percutaneous aortic valve replacement has not only opened up new frontiers in the treatment of severe aortic stenosis, but has also given hope to patients who are not candidates for surgical procedures. However, this procedure is expensive and the perioperative mortality rate is still as high as 10%. However, with advances in material science and interventional techniques, and with the experience of physicians, I am confident that patients with aortic valve disease will be able to benefit more from this treatment in the near future. The replacement of surgical valve replacement by percutaneous aortic valve replacement is just around the corner.