Hi @yorlik,

I'm glad you asked, "HOW can the invasive open heart be better than TAVR," because I'm certain it's a question on many Connect members' minds.

Although transcatheter aortic-valve replacement (TAVR) may seem like an obvious choice, to avoid the stress of an open heart procedure, not everyone is a candidate for it. Doctors are still figuring out how the valves last over time, and there is no data showing how patients fare if they have TAVR and then need to undergo it again because the valve fails. I encourage you to read this article in one of the heart journals, "TAVR: Miracle for Some, but No Improvements in Quality of Life for Others," https://www.tctmd.com/news/tavr-miracle-some-no-improvements-quality-life-others

There are studies that have shown that the durability of the procedure may not be very good. TAVR valves, made from cow or pig tissue, last five to seven years, whereas in open heart surgery, the valves are either made of tissue – last around 10 years – or metal, which lasts 20 to 25 years. https://www.nejm.org/doi/full/10.1056/NEJMoa1700456

According to the American College of Cardiology (ACC), in both TAVR and open-heart surgery, about 25 percent of high-risk patients died within one year, but a point to note is that about 5 percent of TAVR patients had a stroke within a year of the procedure, The same study indicates that up to 25 percent of TAVR patients needed a pacemaker implanted after the procedure. https://www.acc.org/about-acc/press-releases/2016/04/02/10/12/rates-of-death-and-stroke-equivalent-for-surgery-and-tavr-at-two-years

Since it's a relatively new technology, and continually evolving, the procedure is "reserved" for patients for whom an open heart procedure poses intermediate risk. Therefore, most people who have this procedure are in their 70s or 80 and often have other medical conditions that make them a better candidate for this type of surgery. https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/what-is-tavr

As tempting as it sounds to replace aortic valve surgery with a TAVR procedure, there needs to be evidence that is beneficial, not only in the short-term, but also the long-term in patients with aortic valve disease.
I hope this helps answer some of your concerns, @yorlik. Would you be able to share some more details about your diagnosis and upcoming surgery?

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