The introduction of Transcatheter Aortic Valve Implantation (TAVI) has transformed interventional cardiology and minimally invasive cardiac surgery. TAVI is a relatively new technique that is rapidly expanding in its indications and technology as well as places of practice. De-centralisation of this previous supra-specialised procedure can be done safely and efficaciously, to improve the health inequalities across regional and remote Australia. The purpose of this study is to detail the introduction of the TAVI program at a geographically isolated tertiary hospital in regional Australia. Illustrating the safe introduction of TAVI in this location may guide other isolated hospitals on the introduction of the service.