This CPB is revised to state that transcatheter aortic valve implantation (TAVI) by means of the Edwards Sapien transcatheter heart valve is considered medically necessary for trans-femoral or trans-apical delivery in persons with severe symptomatic calcified native aortic valve stenosis without severe aortic insufficiency and with an ejection fraction greater than 20 percent who are operative candidates for aortic valve replacement but who have a Society of Thoracic Surgeons operative risk score greater than or equal to eight percent or are judged to be at 15 percent or greater risk of mortality for surgical aortic valve replacement.