Aortic stenosis
Treatment options in Shanghai

TAVR, also called TAVI, places a replacement valve through a catheter, commonly through a blood vessel, without removing the original valve. Surgical replacement removes the diseased valve and inserts a new one; some operations use smaller chest incisions. These are different procedural routes, not simply newer and older versions of the same operation. Ask which route is being proposed, why access is feasible and whether another heart problem needs treatment during the same operation. Do not assume that a catheter procedure is suitable because the incision is small.

The ESC's 2025 guideline overview emphasises a combination of clinical characteristics, access and valve anatomy, patient preferences and lifetime planning. Age is relevant, but it is not a complete assessment. A practical consultation should explain how your general condition, other illnesses and imaging change the balance. Request input from the relevant interventional, surgical and imaging specialists when appropriate. European guidance informs this discussion; it does not establish Chinese device eligibility or replace the hospital's assessment of which options are currently available for you.

The choice concerns a device that will need continuing surveillance. Ask how expected durability, possible future procedures and medicines fit your situation. Mechanical surgical valves generally require lifelong anticoagulation, which brings monitoring and bleeding considerations. A tissue valve has different long-term trade-offs; it does not mean that you will never need medication or another intervention. Discuss the actual proposed valve rather than relying on a generic lifespan advertised online. If follow-up will occur in another country, identify who will manage medication and interpret future echocardiograms.