Heart valves · Decision guide
Repair, replacement, TAVI or TEER: understand what each option is designed to do.
Valve treatment can preserve a repairable valve, replace a damaged one or use a catheter-based approach. The cause of the valve problem determines which options can work; repair, TAVI and TEER are different treatments.
Durable repair is preferred for suitable severe degenerative mitral regurgitation requiring intervention.
Sources: ESC/EACTS valve guidance (2025)
Mechanical valves require lifelong anticoagulation. Tissue valves can deteriorate and need another intervention.
Sources: NHS: valve types
NHS guidance describes 2–3 hospital days after TAVI versus about a week after surgical replacement.
Sources: NHS: valve recovery
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Sources: ESC/EACTS valve guidance (2025) · NHS: valve recovery
Sources: ESC/EACTS valve guidance (2025) · NHS: valve types
For severe degenerative mitral regurgitation requiring intervention, repair is preferred when a durable reconstruction is feasible. Preserving the native valve avoids a replacement prosthesis, but the chance of repair depends on the specific lesion.
Secondary regurgitation caused by heart-muscle or chamber changes follows a different pathway. Optimized heart-failure treatment and selected catheter interventions may be relevant.
Sources: ESC/EACTS valve guidance (2025) · UK Mini Mitral trial · JAMA (2023) · Mitral and Tricuspid Valve Center | Cleveland Clinic
Mechanical valves offer durability at the cost of lifelong anticoagulation. Tissue valves can deteriorate and may need another intervention. Other conditions can require blood thinners even with a tissue valve.
| Option | Potential advantage | Long-term trade-off |
|---|---|---|
| Mechanical valve | Long durability | Lifelong anticoagulation and bleeding/monitoring burden |
| Tissue valve | No lifelong anticoagulation requirement solely because the valve is mechanical | Structural deterioration and possible reintervention; medicines may still be needed for other reasons |
| Repair | Retains the native valve | Feasibility and durability depend on the lesion and reconstruction |
Sources: NHS: valve types · ESC/EACTS valve guidance (2025)
TAVI places a replacement aortic valve using a catheter. Surgical aortic valve replacement removes and replaces the valve during an operation. The choice includes the valve and access anatomy, other disease, life expectancy, preferences and the likelihood of future procedures.
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 (tricuspid) aortic valve. That is not a universal age rule: bicuspid valves, younger patients and the need for other surgery can change the decision.
Sources: ESC/EACTS valve guidance (2025)
TEER reduces leakage by bringing parts of a valve together with a catheter-delivered device. It is different from surgical repair and from TAVI.
For selected symptomatic severe ventricular secondary mitral regurgitation despite optimized heart-failure treatment, the 2025 European guideline supports TEER to reduce heart-failure admissions and improve quality of life.
Sources: ESC/EACTS valve guidance (2025) · Bumrungrad Heart Valve Center
A mitral repair may be possible through sternotomy, a smaller chest incision or a robot-assisted approach. Choose the repair plan and experienced team together with the access route. The same technique label does not make different valve procedures directly comparable.
Sources: UK Mini Mitral trial · JAMA (2023) · Mayo Clinic: minimally invasive surgery
Valve follow-up includes medication and anticoagulation management where indicated, imaging, rehabilitation and wound review. NHS guidance describes about a week in hospital and two to three months to full recovery after chest-incision valve replacement, with a shorter initial stay after TAVI.
Sources: NHS: valve recovery
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.
Gebze, Kocaeli (Istanbul region) · Turkey
cardiac surgeon
Üstünsoy practises within Anadolu’s programme for complex valve repair and valve-sparing aortic-root replacement. Selected mitral and tricuspid operations can use robotic access.
Sources: Prof. Haşim Üstünsoy | Anadolu Medical Center · Cardiovascular Surgery — Anadolu Medical Center · Robotic Surgery — Anadolu Medical Center
Istanbul · Turkey
cardiac surgeon
Fedakar explicitly lists second and third valve operations among his clinical interests at Hisar.
Sources: Prof. Dr. Ali Fedakar, M.D. | Hisar Intercontinental Hospital
Gurugram · India
cardiac surgeon
Trehan’s listed practice includes valve repair and replacement alongside coronary and aortic disease.
London · United Kingdom
cardiac surgeon
Rosendahl’s stated practice includes repair of the aortic, mitral and tricuspid valves and valve-sparing root replacement.
Sources: Ulrich Rosendahl — clinical expertise and Royal Brompton location
Cleveland, Ohio · United States
cardiac surgeon
Gillinov’s Cleveland Clinic practice includes mitral repair and robotic mitral surgery.
Sources: A. Marc Gillinov, MD | Cleveland Clinic · Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases
Bangkok · Thailand
cardiac surgeon
Ongcharit’s Bumrungrad profile includes valvular disease among his clinical interests.
Sources: Pat Ongcharit, M.D. | Bumrungrad International Hospital · Bumrungrad Heart Valve Center
Continue your guide
Free Bookimed support. Compare options before deciding.
Free Bookimed support. Compare options before deciding.
