TAVI is a way of replacing a narrowed, calcified aortic valve without opening the chest. A new valve is guided on a thin catheter, usually through an artery in the leg, and expanded inside the old valve to take over its function immediately. It is used for people with severe aortic stenosis.
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Severity is graded from three echo numbers: peak jet velocity, mean gradient and valve area. Any one of them being in the severe range matters — and if your ejection fraction is low, the gradients can look falsely reassuring.
These four numbers appear on almost every echocardiography report, usually in the aortic valve section. This tool is educational and never replaces a cardiologist reading the whole study.
At least one criterion is in the severe range. If you have breathlessness, chest tightness or blackouts, no medicine changes the outcome — valve replacement does, and the benefit is immediate. Send the echo and CT and we will tell you within 4 hours whether TAVI or open surgery fits you better.
Get this graded free in 4 hoursSevere aortic stenosis is silent for years, then turns fast. Classical natural-history data shows average survival of roughly 5 years after angina begins, 3 years after breathlessness, and 2 years after the first blackout — unless the valve is replaced.
After a successful valve replacement, survival curves return close to that of the general population of the same age. That is the whole argument for not waiting.
Then: TAVI or open surgery — the heart-team leaning
A real heart team weighs age and expected lifetime against anatomy and surgical risk. This mirrors how that conversation goes — an honest leaning, not a verdict.
tap what applies to you
The final call also needs the CT: annulus size, calcium distribution, coronary height and the width of your leg arteries. That is done free before you commit to anything.
Which valve lasts longest, and what happens in 12 years?
The valve is the single biggest cost item and the single biggest decision. If you are under 75, the first valve must be chosen so a second one can be placed inside it later.
Where it shines: The shortest frame, deployed in a single balloon inflation with the fastest procedure time and the lowest pacemaker rate of the major platforms. Excellent in heavily calcified valves and the default for many valve-in-valve cases.
What to watch: The short frame makes future coronary access easy, but a very small annulus or a low coronary height needs careful CT sizing.
You are likely to outlive this valve, so the plan must include the second one. That means choosing a frame and implant height that keeps your coronary arteries reachable and leaves room for a valve-in-valve later — a conversation to have before, not after.
The route decides whether you are awake or asleep, and whether you walk in hours or days. The CT of your leg arteries settles it.
A 5–6 mm puncture in the femoral artery in the groin — no cut, closed with a suture-based device. You are awake, talking to the team, and there is no breathing tube. This is the reference route and the reason TAVI recovery is measured in hours rather than weeks.
Catheter path for transfemoral (groin artery) — illustrative, not to scale.
Next: what it actually costs, line by line
Pick your situation below for an instant indicative range. Your exact figure comes back within 1 hour of us seeing the echo and CT.
Indicative ranges only. The valve is the largest single line item, so brand and size drive the price more than anything else. Final cost depends on the valve chosen, whether a coronary stent, balloon valvuloplasty or a permanent pacemaker is needed, kidney function and any ICU escalation. We share a written, itemised estimate before you travel and flag anything that could change it.
That was true in 2010. Randomised trials since have extended TAVI to intermediate and low surgical risk patients, and in many countries it now accounts for the majority of aortic valve replacements. The question today is anatomy and expected lifetime, not simply operability.
Out to 8–10 years, TAVI valve durability tracks surgical bioprosthetic valves closely. Beyond that, data is still maturing — which is exactly why a younger patient needs a lifetime plan, not just a valve.
No drug relieves a mechanical obstruction. Once severe stenosis causes breathlessness, chest pain or blackouts, average survival without valve replacement is measured in months to two or three years. Diuretics only mask fluid.
Symptoms often creep in as slowly reduced activity — you stop doing the things that make you breathless. Severe stenosis with a low ejection fraction, a very high gradient or an abnormal stress test carries risk even when you feel adequate.
Serious complications needing surgical rescue occur in well under 1–2% of elective cases at experienced centres — and that is precisely why TAVI should be done where a cardiac surgical team and a hybrid theatre are on site.
The new valve sits next to the heart's electrical wiring, so some patients need a permanent pacemaker afterwards. It is a manageable, planned outcome that does not affect how well the valve works — and valve choice can lower the risk.
Drag through the timeline. This is what makes TAVI different from open surgery — the numbers are hours and days, not months.
The gradient across the valve is measured immediately after deployment — the obstruction is gone within seconds, not weeks. Groin closed with a suture device, no stitches to remove.
From the first WhatsApp message to your one-year echo at home.
The echocardiography report (peak velocity, mean gradient, valve area, ejection fraction), any CT or angiogram, a medicine list and a note on what symptoms you get and after how much walking. Photos of the printed report are fine.
A structural heart cardiologist confirms whether the stenosis is severe, whether TAVI or open surgery fits you better, and what still needs checking. Complex cases go to a full heart-team discussion with a cardiac surgeon.
An itemised estimate with the likely valve brand named, plus a hospital invitation letter for the medical visa, usually issued in 2–4 hours, covering you and your attendants together.
A contrast CT of the aortic root and the leg arteries gives annulus dimensions, calcium pattern, coronary height and access sizing. Blood tests, coronary angiogram and dental screening complete the work-up. The valve size and access route are locked in.
Awake, under local anaesthesia with light sedation in most cases. The valve is delivered through the groin and expanded inside your old valve. The gradient usually drops from severe to near-normal within seconds, measured on the table.
A night in cardiac ICU on rhythm monitoring, mostly to watch the conduction system. You eat, sit up and usually walk the same day. Breathlessness often feels different by the first morning.
A repeat echo confirms valve position, gradient and no significant leak. You leave on a blood thinner plan, with a valve identity card naming the brand and size.
Groin puncture checked, ECG and echo repeated, and clearance to fly. Then video reviews at 1 month, 6 months and one year, with local echo reports read by your operator.
These are typical results at high-volume partner centres doing 200+ TAVI cases a year with an on-site cardiac surgery back-up. Your own result depends on how weak the heart already is, kidney and lung function, frailty and the anatomy on CT.
Most patients go home on single antiplatelet therapy; those with atrial fibrillation need an anticoagulant instead. Getting this combination right matters more than the dose — we send it in writing to you and your local doctor.
Antibiotics before dental work, prompt treatment of skin, chest and urine infections, and no tattoos or piercings. Endocarditis is rare but serious, and dental screening before TAVI is not a formality.
The valve removes the obstruction; graded walking and rehab rebuild the capacity you lost over years. A structured plan in your language, reviewed on WhatsApp at week 6 and month 3.
You get an implant card with the brand, size and implant date. It is MRI-safe, and airport scanners are not a problem — but any future cardiologist needs the card to plan coronary access or a second valve.
No forms, no payment, no obligation. A senior TAVI operator reads your echo and CT and tells you honestly whether the valve needs replacing now, whether TAVI or surgery suits you, which valve and route, and what it will cost.
We reply on WhatsApp — usually within an hour, in your language.
You will be flying with a brand-new valve, so the details matter: oxygen and fitness clearance, enough recovery days before departure, and an attendant beside you. We arrange all of it along with the paperwork.
"82 years old, gradient of 62, and three surgeons had refused to open his chest. TAVI on a Tuesday through the groin, walking the corridor Wednesday, flying home the next week."
"I was fainting on stairs and being told it was my age. The echo went on WhatsApp in the morning and a real cardiologist replied by afternoon with a written price."
"My surgical valve from 2009 had failed. They put a new valve inside the old one — no chest surgery, home in two days, and my breathlessness went away."
In severe aortic stenosis the valve between your heart and the body has calcified into a narrow, stiff opening, so the heart muscle has to generate enormous pressure to push blood past it. TAVI replaces that valve without opening the chest: a collapsed artificial valve is threaded up on a catheter — almost always from a small puncture in the groin — positioned inside the diseased valve under X-ray guidance, and expanded so that it pushes the old leaflets aside and immediately takes over. There is no sternotomy, no heart-lung machine and usually no general anaesthesia. Most patients are awake, walk within hours, and go home in one to three days. Once severe stenosis becomes symptomatic, medicines cannot alter the outcome — only a new valve can.
No forms, no payment, no obligation. A senior TAVI operator reads your echo and CT and tells you honestly whether the valve needs replacing now, whether TAVI or surgery suits you, which valve and route, and what it will cost.