Aortic valve disease · Decision guide

Aortic stenosis, regurgitation and bicuspid valve surgery

Name: Aortic stenosis, regurgitation and bicuspid valve surgery
Creator: Yevhenii Kozlov

Separate a narrowed valve from a leaking valve, then compare repair, replacement, TAVI and any associated aortic operation.

Research by Yevhenii Kozlov · Co-Founder of BookimedUpdated 8 October 2026Sources linked throughout

At a glance

Aortic stenosis is narrowing; regurgitation is leakage; a bicuspid valve has two leaflets. These distinctions change the treatment, and associated aortic disease may require surgery beyond the valve itself.

TAVI treats selected aortic stenosis

The catheter route is not a universal substitute for surgery for every aortic-valve disorder.

Sources: ESC/EACTS valve guidance (2025)

Age and anatomy work together

The 2025 European guideline supports TAVI from age 70 with suitable tricuspid aortic-valve anatomy; other clinical factors still matter.

Sources: ESC/EACTS valve guidance (2025)

Lifetime care differs by valve

Mechanical valves require lifelong anticoagulation; tissue valves may require another intervention.

Sources: NHS: valve types

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Benefits and trade-offs

Potential advantages

Surgery can replace or, in selected anatomy, repair the valve while treating associated aortic or coronary disease.
Sources: ESC/EACTS valve guidance (2025) · ACC/AHA aortic guidance (2022)

Trade-offs and limits

TAVI access, bicuspid anatomy, aortic enlargement and future coronary access can restrict the options.
Sources: 2025 ESC/EACTS Guidelines for the management of valvular heart disease

Three terms that change the discussion

Report wording	Meaning for treatment
Aortic stenosis / AS	Narrowing increases the work needed to eject blood; severity and symptoms guide intervention
Aortic regurgitation / AR	Backward leakage can enlarge or impair the ventricle; valve and root anatomy shape repair or replacement
Bicuspid aortic valve / BAV	Two-leaflet anatomy can coexist with aortic enlargement and change the suitability of catheter treatment

Sources: ESC/EACTS valve guidance (2025) · ACC/AHA aortic guidance (2022) · Aortic valve regurgitation: diagnosis and treatment

TAVI and surgical replacement

For severe aortic stenosis requiring intervention, the 2025 ESC/EACTS guidance supports TAVI in anatomically suitable patients aged 70 or older with a three-leaflet valve. Bicuspid anatomy, younger age, other planned surgery and future interventions require a more individual discussion.

Pure aortic regurgitation means leakage rather than narrowing. Its anatomy and evidence differ from calcific stenosis, so stenosis-based TAVI recommendations do not automatically apply.

Sources: ESC/EACTS valve guidance (2025) · Aortic valve regurgitation: diagnosis and treatment

Heart valves TAVI or valve surgery

A leaking valve: repair, replacement and the aorta

For aortic regurgitation, timing depends on severity, symptoms and progression. Treatment can range from monitoring to repair or replacement. In selected cases the Ross operation is another surgical strategy: the pulmonary valve is moved into the aortic position and the pulmonary position receives a donor valve.

An enlarged aortic root or ascending aorta can require treatment during valve surgery. That creates a combined operation, with a different scope and price from isolated valve replacement.

Sources: Aortic valve regurgitation: diagnosis and treatment · ACC/AHA aortic guidance (2022)

Aortic surgery

The lifetime trade-off

Mechanical replacement trades durability for lifelong anticoagulation. Tissue replacement can reduce that valve-specific anticoagulation burden but can deteriorate. Future valve-in-valve treatment depends on size, anatomy and coronary access.

Sources: ESC/EACTS valve guidance (2025) · NHS: valve types

TAVI and aortic valve surgery cost: compare the full plan

On 8 October 2026, Bookimed’s Turkey TAVI page displayed a Memorial Şişli treatment listing of USD 23,930, and separate Memorial Bahçelievler and Göztepe packages at USD 25,320 labelled “Aortic Valve Replacement via Transapical Approach”. These are differently described offers; they do not establish the price of the same transfemoral procedure.

TAVI costs include the transcatheter valve, access procedure, imaging and hospital care. Surgical replacement costs depend on the prosthesis and any combined bypass, aortic or other valve work. These components explain why a headline TAVI price and a surgical package total may cover different care.

Cost component	What changes the total
Procedure and access	Transfemoral TAVI, another catheter route and surgical replacement have different scopes
Valve or prosthesis	Model and inclusion in the quoted total matter
Additional care	Extra ICU days, pacing or readmission may add charges
Follow-up	Medicine supply, scans and local reviews may extend beyond the package

Sources: TAVI in Turkey: named listings and package scope, 8 October 2026 · ESC/EACTS valve guidance (2025)

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Specialists for this treatment pathway

Explore each specialist’s clinical focus, current programme and the studies relevant to this treatment. The listed roles include cardiac surgeons and, where appropriate, interventional cardiologists.