Both TAVI and surgical aortic valve replacement (SAVR) treat severe aortic stenosis by replacing the diseased valve. The right choice depends on your anatomy, age, surgical risk, and personal circumstances, and is made together with your Heart Team.
At a glance
| TAVI | SAVR (open-heart) | |
|---|---|---|
| Approach | Catheter-based, usually via the groin | Open-chest surgery with sternotomy |
| Anaesthesia | Conscious sedation or general anaesthetic | General anaesthetic with heart-lung bypass |
| Typical hospital stay | 1–3 days | 5–7+ days |
| Return to normal activity | Days to a few weeks | 6–12 weeks |
| Notable risks | Pacemaker requirement, paravalvular leak | Stroke, bleeding, atrial fibrillation |
| Best suited for | Wide range of risk categories; anatomically suitable patients | Younger patients, complex anatomy (e.g. bicuspid valve), or when durability/reintervention flexibility is prioritised |
How the decision is made
Current guidelines support TAVI as an established option across all surgical risk categories, not just high-risk patients. That said, for younger patients, anatomical factors — bicuspid valves, coronary access, and the likelihood of needing a future re-intervention — can favour a “surgery-first” lifetime management strategy. This is why the decision is individualised through a multidisciplinary Heart Team process rather than a single rule.
Prof Walton's Heart Team reviews imaging and personal risk factors for every patient to recommend the most appropriate approach — TAVI, SAVR, or ongoing surveillance. See patient selection criteria for more detail.
This page provides general information about TAVI and is not a substitute for individual medical assessment. Suitability for TAVI is determined through consultation and Heart Team review.