OBJECTIVES: Transcatheter Aortic Valve Implantation (TAVI) is a cost-effective lifesaving therapy for patients suffering from severe aortic stenosis (SAS) who are unable to undergo, or face prohibitively high risk to survival from, conventional open-heart surgery. The therapy is available in Canada on a limited basis, and access lags that in other developed nations. Access issues will become more acute in coming years as the population further ages, though to-date no efforts have been made to quantify need for TAVI procedures and the potentially unavoidable deaths occurring each year from capacity shortfalls. METHODS: We developed a population-based stock-and-flow simulation model using Microsoft EXCEL to quantify the prevalence and incidence of SAS, capacity to perform TAVI procedure, SAS patients longevity  with and without TAVI  and avoidable deaths from lack of access under various capacity-building scenarios for the provinces of Ontario, Quebec, British Columbia and Alberta. Our model was populated with data from published peer-reviewed articles, the StatsCan CANSIM database and the support of the Cardiac Care Network. RESULTS: We estimate that there is a severe shortage of capacity to perform TAVI procedures in relation to population needs that will result in 2,882 avoidable deaths over the three years from 2014 to 2017. The gap between need and capacity is greatest in Ontario. CONCLUSIONS: An increase in the capacity to perform TAVI procedures is needed to reduce the number of access-related mortality in Ontario, Quebec, British Columbia and Alberta.