{"schema_version":"bookimed.page-context.v1","id":"tavi-vs-surgical-valve-replacement","url":"https://hub.bookimed.com/heart-surgery/tavi-vs-surgical-valve-replacement/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/tavi-vs-surgical-valve-replacement.json","index_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/index.json","full_dataset_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/content.json","content_revision":"source-driven-rankings-20261008","date_modified":"2026-10-08","language":"en","kind":"guide","title":"TAVI vs surgical aortic valve replacement: suitability, risks and lifetime planning","summary":"TAVI and surgical replacement can both treat severe aortic stenosis. TAVI introduces a tissue valve by catheter; surgery removes the diseased valve and can also treat associated coronary or aortic disease.","research_credit":{"name":"Yevhenii Kozlov","role":"Co-Founder of Bookimed","url":"https://us-uk.bookimed.com/ceo/kozlov/","contribution":"Research personally prepared and reviewed","assistance":"AI tools assisted source research."},"editorial_scope":"Source-based patient information; an individual treatment plan requires clinical review.","research_method":"How this guide is researched and compared Research project led by Yevhenii Kozlov . We link clinical guidance, primary studies and named hospital or offer sources beside the relevant statements. Comparisons distinguish individual operators from programme results and preserve the study population, follow-up and limitations. Prices are dated examples with their stated scope. Research and editorial preparation are separate from clinical review; no named clinician has medically reviewed this edition. Bookimed provides care coordination. Partner and reference programmes are identified from their sources; paid ordering is not used in our published-cohort comparison. Read the editorial policy .","key_takeaways":[{"label":"2–3 days versus about 1 week","text":"Typical NHS hospital guidance for TAVI and surgical replacement respectively; individual recovery varies.","sources":["C08"]},{"label":"1,000 randomized patients · 7 years","text":"PARTNER 3 found no significant difference in its primary composite outcomes between transfemoral TAVR and surgery in low-risk patients.","sources":["ax-partner3-seven"]},{"label":"Different risk patterns","text":"TAVI more often involves vascular complications, paravalvular leak and new pacemakers; surgery more often involves severe bleeding, kidney injury and new AF in guideline evidence.","sources":["ax-esc-vhd2025"]}],"benefits":[{"text":"TAVI usually reduces the initial hospital and recovery burden; surgery can provide a mechanical valve or combine valve replacement with other cardiac work.","sources":["C04","C08","C03"]}],"limitations":[{"text":"Seven-year trial results do not establish equal lifetime durability in young patients or all devices and anatomies. Future valve and coronary access can constrain the choice.","sources":["ax-partner3-seven","ax-esc-vhd2025"]}],"sections":[{"id":"benefit-balance","title":"Benefits and trade-offs","text":"Benefits and trade-offs Potential advantages TAVI usually reduces the initial hospital and recovery burden; surgery can provide a mechanical valve or combine valve replacement with other cardiac work. Sources: NHS: valve types · NHS: valve recovery · ESC/EACTS valve guidance (2025) Trade-offs and limits Seven-year trial results do not establish equal lifetime durability in young patients or all devices and anatomies. Future valve and coronary access can constrain the choice. Sources: Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years · 2025 ESC/EACTS Guidelines for the management of valvular heart disease","links":[{"label":"NHS: valve types","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/how-its-done/"},{"label":"NHS: valve recovery","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/"},{"label":"ESC/EACTS valve guidance (2025)","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/"},{"label":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/"},{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276"}]},{"id":"scope","title":"First establish whether replacement is indicated","text":"First establish whether replacement is indicated This comparison concerns aortic stenosis: narrowing of the aortic valve. A recommendation must first establish the severity of the disease and the reason to intervene now, considering symptoms, heart function and relevant test findings. Aortic regurgitation, active valve infection and failure of a previously implanted valve need their own assessment. Evidence from trials of native aortic stenosis should not be applied to those problems without qualification. Sources: 2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1 · 2025 ESC/EACTS Guidelines for the management of valvular heart disease: introduction Aortic valve disease ↗ Valve infection ↗ Repeat surgery ↗","links":[{"label":"2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1","url":"https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/12/16/21/58/2020-acc-aha-vhd-gl-pt-1-gl-vhd"},{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease: introduction","url":"https://www.eacts.org/clinical-practice-guideline/2025-esc-eacts-guidelines-for-the-management-of-valvular-heart-disease-developed-by-the-task-force-for-the-management-of-valvular-heart-disease-of-the-european-society-of-cardiology-esc-and-the-eur/"},{"label":"Aortic valve disease ↗","url":"https://hub.bookimed.com/heart-surgery/aortic-valve-disease/"},{"label":"Valve infection ↗","url":"https://hub.bookimed.com/heart-surgery/endocarditis-surgery/"},{"label":"Repeat surgery ↗","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/"}]},{"id":"compare","title":"What differs between TAVI and surgery?","text":"What differs between TAVI and surgery? Feature TAVI / TAVR Surgical replacement Access Catheter, usually via a suitable groin artery Sternotomy or selected smaller chest incision Old valve New valve expands within it Diseased valve is removed Replacement Biological tissue valve Tissue or mechanical valve Heart support Routine TAVI does not require stopping the heart Heart-lung support is used Associated disease Other conditions may need a separate procedure Bypass, aortic repair or another valve procedure may be combined Sources: NHS: valve types · Transcatheter aortic valve replacement (TAVR) · Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines Open-heart surgery ↗ Heart valves ↗","links":[{"label":"NHS: valve types","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/how-its-done/"},{"label":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698"},{"label":"Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/07/22/19/36/Guideline-Update-on-Indications-for-TAVI"},{"label":"Open-heart surgery ↗","url":"https://hub.bookimed.com/heart-surgery/open-heart-surgery/"},{"label":"Heart valves ↗","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgery/"}],"tables":[[["Feature","TAVI / TAVR","Surgical replacement"],["Access","Catheter, usually via a suitable groin artery","Sternotomy or selected smaller chest incision"],["Old valve","New valve expands within it","Diseased valve is removed"],["Replacement","Biological tissue valve","Tissue or mechanical valve"],["Heart support","Routine TAVI does not require stopping the heart","Heart-lung support is used"],["Associated disease","Other conditions may need a separate procedure","Bypass, aortic repair or another valve procedure may be combined"]]]},{"id":"guidelines","title":"What do the guidelines say about age?","text":"What do the guidelines say about age? The 2025 ESC/EACTS guideline recommends TAVI from age 70 for a three-leaflet (tricuspid) aortic valve when anatomy is suitable and access through the groin artery is feasible, and surgery below 70 when surgical risk is low. Other candidates need an individualized Heart Team choice. Here “tricuspid” describes the aortic valve’s three leaflets, not the separate tricuspid valve. Guidelines do not use identical age bands. The 2020 ACC/AHA recommendations favour surgery below 65 or with life expectancy over 20 years; favour transfemoral TAVI above 80 or with life expectancy below 10 years when feasible; and use shared decision-making from 65 to 80 in symptomatic patients suitable for either. These dated frameworks are not automatic eligibility rules. Sources: 2025 ESC/EACTS Guidelines for the management of valvular heart disease · 2025 ESC/EACTS Guidelines for the management of valvular heart disease: official release · 2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1","links":[{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276"},{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease: official release","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/"},{"label":"2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1","url":"https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/12/16/21/58/2020-acc-aha-vhd-gl-pt-1-gl-vhd"}]},{"id":"anatomy","title":"Which findings can change the recommendation?","text":"Which findings can change the recommendation? Echocardiography, CT and coronary assessment establish these anatomical findings. Age and a surgical-risk score add context, but neither defines the entire treatment choice. Finding that changes the choice Why it matters Bicuspid aortic valve Surgery remains the main option, especially in younger patients or with aortic disease. Selected patients at increased surgical risk may be considered for TAVI if anatomy is suitable. Difficult artery access or valve/root anatomy Surgery is generally preferred when the transfemoral route is unsuitable. Other TAVI access routes may be considered when surgery is unsuitable. Aorta disease, complex coronary disease or another valve problem Surgery may address more than one problem in a single operation. Major frailty or serious illness beyond the valve The team must assess likely survival, symptom relief and quality-of-life benefit from either treatment. Small valve opening and a long expected lifespan The size and design chosen now can affect later valve treatment. Sources: 2025 ESC/EACTS Guidelines for the management of valvular heart disease · 2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1 · Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines Aortic surgery ↗","links":[{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276"},{"label":"2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1","url":"https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/12/16/21/58/2020-acc-aha-vhd-gl-pt-1-gl-vhd"},{"label":"Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/07/22/19/36/Guideline-Update-on-Indications-for-TAVI"},{"label":"Aortic surgery ↗","url":"https://hub.bookimed.com/heart-surgery/aortic-surgery/"}],"tables":[[["Finding that changes the choice","Why it matters"],["Bicuspid aortic valve","Surgery remains the main option, especially in younger patients or with aortic disease. Selected patients at increased surgical risk may be considered for TAVI if anatomy is suitable."],["Difficult artery access or valve/root anatomy","Surgery is generally preferred when the transfemoral route is unsuitable. Other TAVI access routes may be considered when surgery is unsuitable."],["Aorta disease, complex coronary disease or another valve problem","Surgery may address more than one problem in a single operation."],["Major frailty or serious illness beyond the valve","The team must assess likely survival, symptom relief and quality-of-life benefit from either treatment."],["Small valve opening and a long expected lifespan","The size and design chosen now can affect later valve treatment."]]]},{"id":"risks","title":"Which risks should the team compare?","text":"Which risks should the team compare? Both approaches have risks, including stroke, bleeding, infection and death. Across the evidence summarized in the 2025 guideline, vascular complications, leakage around the valve and new pacemakers occur more often after TAVI; severe bleeding, acute kidney injury and new atrial fibrillation occur more often after surgery. These patterns do not predict an individual outcome. Request procedure-specific estimates for someone with similar anatomy and health. A low surgical risk score does not answer every question about TAVI anatomy or future procedures, and a shorter initial stay is not the same outcome as long-term survival. Sources: Transcatheter aortic valve replacement (TAVR) · 2025 ESC/EACTS Guidelines for the management of valvular heart disease · Heart Surgery: Risks · STS risk calculators · STS rating methodology Open-heart surgery ↗ Compare surgeon expertise ↗","links":[{"label":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698"},{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276"},{"label":"Heart Surgery: Risks","url":"https://www.nhlbi.nih.gov/health/heart-surgery/risks"},{"label":"STS risk calculators","url":"https://www.sts.org/resources/calculators-tools/sts-risk-calculators"},{"label":"STS rating methodology","url":"https://publicreporting.sts.org/acsd-exp"},{"label":"Open-heart surgery ↗","url":"https://hub.bookimed.com/heart-surgery/open-heart-surgery/"},{"label":"Compare surgeon expertise ↗","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/"}]},{"id":"evidence","title":"What does seven-year randomized evidence show?","text":"What does seven-year randomized evidence show? PARTNER 3 randomized 1,000 patients with severe, symptomatic aortic stenosis and low surgical risk to transfemoral TAVR or surgery. At seven years, the estimated combined incidence of death, stroke or relevant rehospitalization was 34.6% after TAVR and 37.2% after surgery; the difference was −2.6 percentage points (95% confidence interval −9.0 to 3.7). The primary comparisons did not show a statistically significant difference. Bioprosthetic valve failure was reported in 6.9% and 7.5%, respectively. This is useful follow-up for the studied population and valve approach, not proof of equal lifetime durability in younger patients, all anatomies or every device. These combined seven-year events are not procedural death rates. The study was funded by Edwards Lifesciences; the report appeared online in 2025 and in the 2026 journal issue. Sources: Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years","links":[{"label":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/"}]},{"id":"lifetime","title":"Plan the next intervention before choosing the first","text":"Plan the next intervention before choosing the first A tissue valve can deteriorate. Another catheter valve inside it may be possible, but it is not a guaranteed future solution. Planning needs to consider space for another valve, the risk of blocking a coronary artery and whether those arteries will remain accessible for future treatment. A mechanical valve offers a different durability trade-off and requires lifelong anticoagulation. Its suitability depends on the person’s circumstances and preferences; TAVI does not offer a mechanical-valve option. A tissue valve can deteriorate and require another intervention. Valve size and coronary anatomy can limit future valve-in-valve treatment. A future valve can affect access to the coronary arteries. A mechanical valve offers durability with lifelong anticoagulation; TAVI does not provide this option. Sources: 2025 ESC/EACTS Guidelines for the management of valvular heart disease · NHS: valve types · Transcatheter aortic valve replacement (TAVR) Heart valves ↗ Repeat surgery ↗","links":[{"label":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276"},{"label":"NHS: valve types","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/how-its-done/"},{"label":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698"},{"label":"Heart valves ↗","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgery/"},{"label":"Repeat surgery ↗","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/"}]},{"id":"recovery","title":"Recovery and follow-up: a shorter stay still needs a plan","text":"Recovery and follow-up: a shorter stay still needs a plan NHS guidance describes roughly two to three days in hospital after TAVI versus about a week after surgical valve replacement, with two to three months for full recovery after chest surgery. Actual discharge and recovery vary; these are general patient-information timelines, not a promise for a particular centre. Both treatments require valve surveillance and medication review after discharge. Early walking, rehabilitation and return travel follow different milestones; a shorter hospital stay does not remove the need for continuing cardiac care. Sources: NHS: valve recovery · Transcatheter aortic valve replacement (TAVR) Recovery ↗ Costs & quotes ↗","links":[{"label":"NHS: valve recovery","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/"},{"label":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698"},{"label":"Recovery ↗","url":"https://hub.bookimed.com/heart-surgery/recovery/"},{"label":"Costs & quotes ↗","url":"https://hub.bookimed.com/heart-surgery/cost/"}]},{"id":"matching-specialists","title":"Specialists for this treatment pathway","text":"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. Portrait source ↗ Cleveland, Ohio · United States interventional cardiologist Samir Kapadia → Kapadia is a Cleveland Clinic interventional cardiologist specialising in TAVR and other catheter valve therapies. Cleveland Clinic → Sources: Samir Kapadia, MD View expertise and research → EL Paris · France cardiac surgeon Emmanuel Lansac → Lansac’s research combines aortic-root remodelling with external support of the valve annulus to retain the natural aortic valve. AP-HP Pitié-Salpêtrière → Sources: External aortic annuloplasty with a dedicated expansible ring improves outcomes in remodeling root repair compared with homemade Dacron ring. · Dr Emmanuel Lansac View expertise and research → Portrait source ↗ Durham, North Carolina · United States cardiac surgeon G. Chad Hughes → Hughes lists aortic valve repair and valve-sparing root replacement among his Duke clinical areas. Duke University Hospital → Sources: G. Chad Hughes, MD · Mid-term outcomes of aortic valve repair using an anatomically shaped internal annuloplasty ring. View expertise and research → Portrait source ↗ London · United Kingdom cardiac surgeon Ulrich Rosendahl → Rosendahl’s stated practice includes repair of the aortic, mitral and tricuspid valves and valve-sparing root replacement. Royal Brompton Hospital → Sources: Ulrich Rosendahl — clinical expertise and Royal Brompton location View expertise and research → Portrait source ↗ Cleveland, Ohio · United States cardiac surgeon A. Marc Gillinov → Gillinov’s Cleveland Clinic practice includes mitral repair and robotic mitral surgery. Cleveland Clinic → Sources: A. Marc Gillinov, MD | Cleveland Clinic · Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases View expertise and research → Portrait source ↗ Gurugram · India cardiac surgeon Nitin Kumar Rajput → Rajput’s listed valve work includes endoscopic mitral and aortic replacement and repeat valve replacement. Medanta → Sources: Cardiac Surgery Experts in Gurugram — Medanta View expertise and research → Browse the full specialist directory →","links":[{"label":"Portrait source ↗","url":"https://my.clevelandclinic.org/staff/5003-samir-kapadia"},{"label":"Samir Kapadia →","url":"https://hub.bookimed.com/heart-surgery/doctor-samir-kapadia/"},{"label":"Cleveland Clinic →","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/"},{"label":"Samir Kapadia, MD","url":"https://my.clevelandclinic.org/staff/5003-samir-kapadia"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-samir-kapadia/"},{"label":"Emmanuel Lansac →","url":"https://hub.bookimed.com/heart-surgery/doctor-emmanuel-lansac/"},{"label":"AP-HP Pitié-Salpêtrière →","url":"https://hub.bookimed.com/heart-surgery/clinic-pitie-salpetriere/"},{"label":"External aortic annuloplasty with a dedicated expansible ring improves outcomes in remodeling root repair compared with homemade Dacron ring.","url":"https://pubmed.ncbi.nlm.nih.gov/38914371/"},{"label":"Dr Emmanuel Lansac","url":"https://www.aphp.fr/dr-lansac-emmanuel"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-emmanuel-lansac/"},{"label":"Portrait source ↗","url":"https://www.dukehealth.org/find-doctors-physicians/g-chad-hughes-md"},{"label":"G. Chad Hughes →","url":"https://hub.bookimed.com/heart-surgery/doctor-g-chad-hughes/"},{"label":"Duke University Hospital →","url":"https://hub.bookimed.com/heart-surgery/clinic-duke/"},{"label":"G. Chad Hughes, MD","url":"https://www.dukehealth.org/find-doctors-physicians/g-chad-hughes-md"},{"label":"Mid-term outcomes of aortic valve repair using an anatomically shaped internal annuloplasty ring.","url":"https://pubmed.ncbi.nlm.nih.gov/38006340/"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-g-chad-hughes/"},{"label":"Portrait source ↗","url":"https://www.rbht.nhs.uk/specialists/mr-ulrich-rosendahl"},{"label":"Ulrich Rosendahl →","url":"https://hub.bookimed.com/heart-surgery/doctor-ulrich-rosendahl/"},{"label":"Royal Brompton Hospital →","url":"https://hub.bookimed.com/heart-surgery/clinic-rbht/"},{"label":"Ulrich Rosendahl — clinical expertise and Royal Brompton location","url":"https://guysandstthomasspecialistcare.co.uk/specialists/ulrich-rosendahl/"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-ulrich-rosendahl/"},{"label":"Portrait source ↗","url":"https://providers.clevelandclinic.org/provider/a-marc-gillinov/4268438"},{"label":"A. Marc Gillinov →","url":"https://hub.bookimed.com/heart-surgery/doctor-marc-gillinov/"},{"label":"Cleveland Clinic →","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/"},{"label":"A. Marc Gillinov, MD | Cleveland Clinic","url":"https://providers.clevelandclinic.org/provider/a-marc-gillinov/4268438"},{"label":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","url":"https://pubmed.ncbi.nlm.nih.gov/28893396/"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-marc-gillinov/"},{"label":"Portrait source ↗","url":"https://www.medanta.org/doctor-listing/cardiac-surgery-doctors-in-gurugram?page=1"},{"label":"Nitin Kumar Rajput →","url":"https://hub.bookimed.com/heart-surgery/doctor-nitin-rajput/"},{"label":"Medanta →","url":"https://hub.bookimed.com/heart-surgery/clinic-medanta/"},{"label":"Cardiac Surgery Experts in Gurugram — Medanta","url":"https://www.medanta.org/doctor-listing/cardiac-surgery-doctors-in-gurugram?page=1"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-nitin-rajput/"},{"label":"Browse the full specialist directory →","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgeons/"}]}],"introduction":"Heart surgery guide / TAVI or valve surgery TAVI or valve surgery · Decision guide TAVI vs surgical aortic valve replacement: suitability, risks and lifetime planning Compare the treatment that fits the valve and the person, including what might be needed years later. Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources linked throughout At a glance TAVI and surgical replacement can both treat severe aortic stenosis. TAVI introduces a tissue valve by catheter; surgery removes the diseased valve and can also treat associated coronary or aortic disease. 2–3 days versus about 1 week Typical NHS hospital guidance for TAVI and surgical replacement respectively; individual recovery varies. Sources: NHS: valve recovery 1,000 randomized patients · 7 years PARTNER 3 found no significant difference in its primary composite outcomes between transfemoral TAVR and surgery in low-risk patients. Sources: Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years Different risk patterns TAVI more often involves vascular complications, paravalvular leak and new pacemakers; surgery more often involves severe bleeding, kidney injury and new AF in guideline evidence. Sources: 2025 ESC/EACTS Guidelines for the management of valvular heart disease","related_documents":[{"id":"heart-surgery","title":"Heart surgery abroad: treatments, clinics and costs","kind":"home","url":"https://hub.bookimed.com/heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-surgery.json"},{"id":"heart-valve-surgery","title":"Heart valve surgery: repair, replacement and catheter options","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-valve-surgery.json"},{"id":"aortic-surgery","title":"Aortic aneurysm surgery: options and specialist teams","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/aortic-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/aortic-surgery.json"},{"id":"cost","title":"Heart surgery costs: valve surgery and CABG quotes","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/cost/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/cost.json"},{"id":"recovery","title":"Recovery after heart surgery: hospital, home and travel","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/recovery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/recovery.json"},{"id":"second-opinion","title":"Prepare for a heart surgery second opinion","kind":"inquiry","url":"https://hub.bookimed.com/heart-surgery/second-opinion/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/second-opinion.json"},{"id":"aortic-valve-disease","title":"Aortic stenosis, regurgitation and bicuspid valve surgery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/aortic-valve-disease/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/aortic-valve-disease.json"},{"id":"endocarditis-surgery","title":"Endocarditis: valve infection and surgical assessment","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/endocarditis-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/endocarditis-surgery.json"},{"id":"repeat-heart-surgery","title":"Repeat heart surgery: reoperation and alternative approaches","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/repeat-heart-surgery.json"},{"id":"surgeon-rankings","title":"Heart surgeon rankings by reported experience, method and results","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeon-rankings.json"},{"id":"open-heart-surgery","title":"Open-heart surgery and sternotomy: procedures, alternatives and recovery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/open-heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/open-heart-surgery.json"},{"id":"doctor-ulrich-rosendahl","title":"Ulrich Rosendahl: Coronary bypass specialist","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-ulrich-rosendahl/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-ulrich-rosendahl.json"},{"id":"doctor-marc-gillinov","title":"A. Marc Gillinov: Mitral repair specialist","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-marc-gillinov/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-marc-gillinov.json"},{"id":"doctor-nitin-rajput","title":"Nitin Kumar Rajput: Coronary bypass specialist","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-nitin-rajput/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-nitin-rajput.json"},{"id":"doctor-emmanuel-lansac","title":"Emmanuel Lansac: aortic valve repair and root remodelling","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-emmanuel-lansac/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-emmanuel-lansac.json"},{"id":"doctor-g-chad-hughes","title":"G. 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Its TAVI candidacy wording is narrower than 2025 ESC/EACTS; do not use it to restrict TAVI to high-risk/inoperable patients."},"C08":{"id":"C08","title":"Recovering from a heart valve replacement","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/","publisher":"NHS","published":"2025-07-17 (review)","read_at":"2026-10-08","source_type":"National health service patient information","body_access":"full_public_page_read","support_location":"How to recover; Recovering in hospital; Recovering at home"},"C11":{"id":"C11","title":"STS Risk Calculators","url":"https://www.sts.org/resources/calculators-tools/sts-risk-calculators","publisher":"Society of Thoracic Surgeons","published":null,"read_at":"2026-10-08","source_type":"Registry owner's tool description","body_access":"full_public_page_read","support_location":"Adult Cardiac Risk Calculators: ACSD Operative Risk Calculator and procedure-specific calculators"},"C13":{"id":"C13","title":"Explanation of STS Adult Cardiac Surgery Database Ratings","url":"https://publicreporting.sts.org/acsd-exp","publisher":"Society of Thoracic Surgeons","published":null,"read_at":"2026-10-08","source_type":"Registry methodology","body_access":"full_public_page_read","support_location":"Risk Adjustment; Composite quality ratings, patient populations and reporting periods"},"rbht-profile":{"id":"rbht-profile","title":"Mr Ulrich Rosendahl | Royal Brompton & Harefield hospitals","url":"https://www.rbht.nhs.uk/specialists/mr-ulrich-rosendahl","read_at":"2026-10-07","source_type":"official_hospital"},"cleveland-profile":{"id":"cleveland-profile","title":"A. Marc Gillinov, MD | Cleveland Clinic","url":"https://providers.clevelandclinic.org/provider/a-marc-gillinov/4268438","read_at":"2026-10-07","source_type":"official_hospital"},"mitral-cleveland-robotic-learning-0":{"url":"https://pubmed.ncbi.nlm.nih.gov/28893396/","doi":"10.1016/j.jtcvs.2017.07.037","title":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","published":"2018 issue; 2017 online","access_note":"Primary abstract text acquired in web search; direct PubMed route returned a cookies challenge. Full article not inspected. Recovery via Europe PMC attempted.","id":"mitral-cleveland-robotic-learning-0","publisher":"Primary journal article","read_at":"2026-10-07","source_type":"Institutional first1000 robotic operations; primary journal abstract plus current official programme body"},"medanta-surgeons":{"url":"https://www.medanta.org/doctor-listing/cardiac-surgery-doctors-in-gurugram?page=1","title":"Cardiac Surgery Experts in Gurugram — Medanta"},"rbht-rosendahl-current":{"url":"https://guysandstthomasspecialistcare.co.uk/specialists/ulrich-rosendahl/","title":"Ulrich Rosendahl — clinical expertise and Royal Brompton location","publisher":"Guy’s and St Thomas’ Specialist Care"},"cleveland-mitral1000":{"url":"https://pubmed.ncbi.nlm.nih.gov/28893396/","title":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","publisher":"Journal of Thoracic and Cardiovascular Surgery"},"ax-nih-risks":{"id":"ax-nih-risks","title":"Heart Surgery: Risks","url":"https://www.nhlbi.nih.gov/health/heart-surgery/risks","publisher":"NHLBI, NIH","published":"2022-06-01","read_at":"2026-10-08","source_type":"Government patient information","source_kind":"Government patient information","body_access":"full_public_page_read","support_location":"Complication list and factors associated with higher risk"},"ax-mayo-tavi":{"id":"ax-mayo-tavi","title":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698","publisher":"Mayo Clinic","published":"2025-08-12","read_at":"2026-10-08","source_type":"Hospital patient information","source_kind":"Hospital patient information","body_access":"full_public_page_read","support_location":"Overview; Risks; During; After","access_limit":"Used for technique, risks and follow-up, not current guideline age thresholds."},"ax-acc-vhd2020":{"id":"ax-acc-vhd2020","title":"2020 ACC/AHA Heart Valve Disease Guideline: Key Perspectives, Part 1","url":"https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/12/16/21/58/2020-acc-aha-vhd-gl-pt-1-gl-vhd","publisher":"American College of Cardiology","published":"2020-12-17","read_at":"2026-10-08","source_type":"Official society guideline summary","source_kind":"Official society guideline summary","body_access":"full_public_page_read","support_location":"Points 5–6: intervention and mode of intervention","access_limit":"Explicitly dated US guideline summary; not relabelled as a 2025/2026 update."},"ax-acc-tavi2020":{"id":"ax-acc-tavi2020","title":"Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/07/22/19/36/Guideline-Update-on-Indications-for-TAVI","publisher":"American College of Cardiology","published":"2021-07-22","read_at":"2026-10-08","source_type":"Official society guideline summary","source_kind":"Official society guideline summary","body_access":"full_public_page_read","support_location":"Points 1, 7–8: anatomy, excluded trial populations and concomitant disease","access_limit":"The page’s 5-year durability horizon is outdated; not used for current long-term evidence."},"ax-eacts2025-introduction":{"id":"ax-eacts2025-introduction","title":"2025 ESC/EACTS Guidelines for the management of valvular heart disease: introduction","url":"https://www.eacts.org/clinical-practice-guideline/2025-esc-eacts-guidelines-for-the-management-of-valvular-heart-disease-developed-by-the-task-force-for-the-management-of-valvular-heart-disease-of-the-european-society-of-cardiology-esc-and-the-eur/","publisher":"European Association for Cardio-Thoracic Surgery","published":"2025-08-29","read_at":"2026-10-08","source_type":"Guideline-owning society publication","source_kind":"Guideline-owning society publication","body_access":"full_public_page_read","support_location":"Introduction: advanced imaging, mode of intervention, BAV/AR, separate guidelines for overlapping diseases"},"ax-esc-vhd2025":{"id":"ax-esc-vhd2025","title":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://doi.org/10.1093/ejcts/ezaf276","publisher":"ESC/EACTS; European Journal of Cardio-Thoracic Surgery","published":"2025-08-29","read_at":"2026-10-08","source_type":"Clinical practice guideline","source_kind":"Clinical practice guideline","body_access":"original_guideline_PDF_relevant_sections_read","support_location":"Original PDF pp. 33–36: sections 8.5, 8.5.1, 8.5.1.1–8.5.1.3; p. 34 comparative complications and access; p. 35 BAV; p. 36 lifetime planning and age recommendations","doi":"10.1093/ejcts/ezaf276","body_file":"sources/esc2025-ejcts.pdf","text_file":"sources/esc2025-ejcts.txt","body_url":"https://matcvs.org.my/documents/guidelines/2025%20ESC%20EACTS%20Valvular%20Heart%20Disease%20Guidelines.pdf","access_limit":"OUP/ESC direct routes returned access errors. Complete original co-published EJCTS PDF retrieved from Malaysian Association for Thoracic and Cardiovascular Surgery; title/authors/DOI and statement that EJCTS/EHJ versions are identical except style verified on p. 1. Only relevant pp. 1 and 33–37 inspected, not all 109 pages."},"ax-esc2025-release":{"id":"ax-esc2025-release","title":"2025 ESC/EACTS Guidelines for the management of valvular heart disease: official release","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/","publisher":"European Society of Cardiology","published":"2025-08-29","read_at":"2026-10-08","source_type":"Official guideline release overview","source_kind":"Official guideline release overview","body_access":"full_public_page_read","support_location":"Aortic stenosis: age 70, tricuspid valve, suitable anatomy, younger patients, lifetime trajectory","access_limit":"Overview is kept separate from the recovered full guideline."},"ax-partner3-seven":{"id":"ax-partner3-seven","title":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/","publisher":"New England Journal of Medicine","published":"2025-10-27 online; 2026-02-19 issue","read_at":"2026-10-08","source_type":"Primary randomized trial follow-up","source_kind":"Primary randomized trial follow-up","body_access":"complete_original_abstract_read_via_Europe_PMC","support_location":"Original abstract Methods, Results and Conclusions","doi":"10.1056/NEJMoa2509766","body_file":"sources/partner3.json","access_limit":"NEJM full-text route returned 403. Complete original abstract read via Europe PMC. No device-specific leakage/pacemaker comparison extracted from an unread supplement."},"pd-adult-lansac-official":{"title":"Dr Emmanuel Lansac","publisher":"AP-HP","url":"https://www.aphp.fr/dr-lansac-emmanuel","read_at":"2026-10-08","kind":"official provider or programme page","support":"Current Pitié-Salpêtrière cardiac/thoracic surgery consultation listing.","limitations":"An institutional listing supports current role and stated clinical scope; it does not establish the next appointment, operating allocation or individual risk-adjusted results.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/lansac-official.txt"},"pd-adult-hughes-official":{"title":"G. Chad Hughes, MD","publisher":"Duke Health","url":"https://www.dukehealth.org/find-doctors-physicians/g-chad-hughes-md","read_at":"2026-10-08","kind":"official provider or programme page","support":"Active adult heart surgeon; valve repair, valve-sparing root, arch, thoracoabdominal, TEVAR and TAVR expertise.","limitations":"An institutional listing supports current role and stated clinical scope; it does not establish the next appointment, operating allocation or individual risk-adjusted results.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/hughes-official.txt"},"pd-adult-kapadia-official":{"title":"Samir Kapadia, MD","publisher":"Cleveland Clinic","url":"https://my.clevelandclinic.org/staff/5003-samir-kapadia","read_at":"2026-10-08","kind":"official provider or programme page","support":"Current cardiovascular medicine chair; interventional cardiologist, TAVR and complex coronary intervention expertise.","limitations":"An institutional listing supports current role and stated clinical scope; it does not establish the next appointment, operating allocation or individual risk-adjusted results.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/kapadia-official.txt"},"pd-adult-lansac375":{"title":"External aortic annuloplasty with a dedicated expansible ring improves outcomes in remodeling root repair compared with homemade Dacron ring.","publisher":"The Journal of thoracic and cardiovascular surgery","url":"https://pubmed.ncbi.nlm.nih.gov/38914371/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/lansac375.json","published_at":"2024-06-22","doi":"10.1016/j.jtcvs.2024.06.013","authors":"Shraer N, Youssefi P, Garufi L, Debauchez M, Lansac E."},"pd-adult-partner3":{"title":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.","publisher":"The New England journal of medicine","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/partner3.json","published_at":"2025-10-27","doi":"10.1056/nejmoa2509766","authors":"Leon MB, Mack MJ, Pibarot P, Hahn RT, Thourani VH, Kodali SH, Généreux P, Kapadia SR, Cohen DJ, Pocock SJ, Zhang Y, Szerlip M, Ternacle J, Malaisrie SC, Herrmann HC, Szeto WY, Russo MJ, Babaliaros V, Nazif T, Webb JG, Makkar RR, PARTNER 3 Investigators."},"pd-adult-hughes71":{"title":"Mid-term outcomes of aortic valve repair using an anatomically shaped internal annuloplasty ring.","publisher":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","url":"https://pubmed.ncbi.nlm.nih.gov/38006340/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/hughes71.json","published_at":"2023-12-01","doi":"10.1093/ejcts/ezad395","authors":"Jarral OA, Jensen CW, Doberne JW, Downey PS, Serfas JD, Vekstein AM, Hughes GC."}}}