No. of Recommendations: 16
This post may be on-topic because so many Americans have aortic valve stenosis (narrowing of an important valve in the heart) and also because other METARs may need the information.
I was diagnosed with severe aortic valve stenosis in 2024 as a result of a nurse practitioner listening to my heart when I stopped into the clinic for an unrelated issue. My primary care doctor never bothered to listen to my heart since I worked out almost daily and was physically fit. I was feeling more tired but after all I was over 65. It didn’t occur to me that my heart was failing.
Ultrasound and CT showed that I had a birth defect. My aortic valve had only two leaflets (bicuspid) instead of the normal three leaflets. The valve was like a clam shell shape which couldn’t open fully. Plus it had become heavily calcified and stiff. As a result of a very small opening (1 square cm) the jet of blood was like a garden hose and caused an aneurysm in my ascending aorta over years of vigorous aerobic exercise. The word “severe” in the report definitely got my attention.
When I read about the modern minimally-invasive procedure of TAVR (which is like sliding a stent with a valve through the artery into the heart) it seemed so perfect. Compared with TAVR, open-heart surgery seemed so brutal and old-fashioned.
But my cardiologist said that my fitness showed that I could live another 15 years. The TAVR valve would have to be small to fit inside my calcified aortic valve - maybe 19 mm. In 15 years it would be worn out. The space for a new slide-in valve would be restricted.
Also, research showed that some of the TAVR valves didn’t fit exactly into the calcified valve. Blood leaked around the TAVR valve which is a pressure fit and not sewn in. My stiff clam shell-shaped valve wasn’t round. I was at high risk for outside leakage.
That’s why I opted for the open-heart surgery. Also I needed to have that aneurysm fixed which could only be done surgically.
My new valve is the largest they make - 25 mm. It’s specifically designed to accept a new slide-in valve when that’s needed in maybe 10 to 15 years. The surgery was a bear but it was easier at age 70 than it would be at age 80. Fluid leaked out into the space around my lungs (pleural effusion). My lungs partially collapsed. Measure lung volume was 500 cc. I was in the hospital on oxygen 24/7 for 9 days. Once home, I was so weak that I needed a chair to shower.
I’m just now beginning to feel more like myself again - the recovery took many months, close to a year or maybe even more. Cardiac rehab helped but I was also exercising daily on my own.
An old college friend had TAVR a couple of months before I had SAVR (surgical aortic valve replacement). He was out of the hospital in 2 days and felt fine. A no-brainer, right?
https://www.wsj.com/health/healthcare/heart-valve-...
A Breakthrough Heart Procedure Comes With Risky Tradeoffs
A minimally invasive alternative to open heart surgery is gaining popularity, but some find their new valves don’t work as well or last as long as they hoped
By Betsy McKay, The Wall Street Journal, April 23, 2026
…
Transcatheter aortic valve replacement, or TAVR, is considered one of the biggest innovations in cardiovascular medicine, offering a way to spare patients the physical and emotional trauma of open heart surgery…
Yet there’s limited research on how long the valves might last. And as TAVR has become more widely used among younger and healthier people, some are finding that their valves don’t work as well or last as long as they hoped. The procedure they thought would spare them a complicated surgery leads some to the operating table anyway…
More than 710,000 Americans received a TAVR between 2015 and 2024. The procedure is designed to treat severe aortic stenosis, in which calcium buildup narrows the opening of the aortic valve. Symptoms include fatigue, shortness of breath, chest pain and a fluttering heartbeat. Aortic stenosis affects at least 1.5 million Americans, and if severe and left untreated, can lead to heart failure and death.
TAVR is an appealing option for patients and doctors because it’s a simpler, less invasive procedure than a surgical aortic valve replacement (SAVR), with shorter recovery times…
Doctors are concerned by recent data from another clinical trial in low-risk patients suggesting that some TAVR valves may wear out faster than their surgical counterparts.
Some TAVR patients end up needing an “explant,” a complex surgery to remove the original aortic valve along with the TAVR valve and sew in a new surgical one. While uncommon, the explant is the fastest-growing type of cardiac surgery, by rate, in the U.S. today. It is a riskier operation than regular surgical aortic valve replacement…
“Almost nobody’s thinking about what’s next,” he said.
Valve makers and many doctors say when a TAVR valve wears out, a new valve can be inserted inside the old one, like Russian nesting dolls. The number of patients undergoing a second TAVR procedure after their valve wears out is also growing. But little is known about how long second TAVR valves last, and the nesting doll procedure doesn’t work for everyone.
Market expansion
Edwards Lifesciences, Medtronic and other companies have built TAVR into a global business with $7.02 billion in 2025 revenue, estimated to increase to $9.91 billion in 2030… [end quote]
The charts in the article show that the number of TAVR replacements is growing fast. Since TAVR first became widely used in 2015 it’s only been slightly over 10 years for a device which is expected to have an average life of 10 years. Research shows that about 1.5% of the devices fail but it will take longer experience to learn how many fail earlier since the numbers only picked up recently.
I know an 83 year old woman who just got her second TAVR. She’s feeling fine. She never had open heart surgery. But she doesn’t do heavy exercise.
The companies that make the valves are encouraging TAVR in younger, healthier patients with longer life expectancy. It seems like a no-brainer since it’s so fast and easy.
But anyone with an aortic valve problem needs to think carefully and clearly about the risks in their specific case.
My husband pointed the WSJ article out to me. I think he wasn’t truly convinced about my choice of SAVR until he read it.
Wendy
