TAVR or surgery for aortic stenosis: what a Shanghai assessment should compare

Confirm the valve problem and its effect

Aortic stenosis means that the aortic valve does not open adequately; it is different from a valve that mainly leaks. Bring your echocardiogram report and available images, together with a timeline of breathlessness, chest discomfort, dizziness or reduced activity. The specialist needs to relate symptoms to valve severity and other possible causes. Ask what findings establish a need for intervention now and what would support continued monitoring. Absence of symptoms alone should not be used to decide that a severe valve problem can safely wait.

Sources and references: [1] [2]

Understand what the two routes actually involve

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.

Sources and references: [3]

Ask the Heart Team to explain the trade-off

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.

Sources and references: [2]

Discuss the valve beyond the first admission

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.

Sources and references: [2] [3]

Use Shanghai resources for a specific clinical question

For severe aortic stenosis, the first task in Shanghai is not to choose “TAVR” or “open surgery” from a menu, but to have a heart team compare them for you. Zhongshan Hospital, Fudan University has cardiovascular expertise and a history of transcatheter valve work. With echocardiography, CT, coronary information and earlier operation records, the team can weigh anatomy, short-term risk, valve durability and long-term follow-up in one decision. Start with our Aortic stenosis guide, then bring your main question to eastmedgo.

Sources and references: [6] [7]

Compare risks, not only recovery speed

Valve replacement can involve bleeding, infection, rhythm problems, kidney injury, blood clots, stroke or later valve dysfunction. Ask the team which risks matter most for your proposed procedure and health, including whether a pacemaker or further treatment might be needed. A shorter recovery expectation does not erase these possibilities. The decision should also address the risk of leaving significant disease untreated. Request instructions for warning symptoms and emergency access. New severe breathing difficulty, acute concerning chest pain or stroke symptoms require urgent local assessment, not a wait for travel.

Sources and references: [4]

Obtain a staged, itemised estimate

Ask for separate estimates for consultation and imaging review, additional investigations, the valve and other devices, the procedure, anaesthesia, hospital care and follow-up. Clarify how a change in procedure, an extended admission or treatment of complications would affect the estimate. The lower headline price may cover a different scope. Coordination fees, accommodation and travel should be listed separately, with no assumed insurance approval or guaranteed total. eastmedgo can organise the records needed for comparing TAVR and surgery using echo, CT and long-term valve needs, match you with Shanghai specialists and coordinate bilingual communication and return-home handover. To see how coordination works, read about eastmedgo's services or contact us with your records.

Plan the handover before selecting a return date

Discharge, readiness for a long journey and full recovery are different milestones. Ask the treating team to specify wound care, activity advice, medication, follow-up testing and whether cardiac rehabilitation is suitable. Obtain the procedure summary and device information for the doctor at home. If anticoagulation is prescribed, confirm who monitors it and how results reach the responsible clinician; do not adjust it independently. Arrange help during early recovery. A personalised return plan is more useful than copying a hospital-stay figure from a general information page.

Sources and references: [5]

Common questions