Why the choice is not simply TAVI versus surgery
Aortic valve replacement is not a single procedure with two interchangeable versions. TAVI and surgical aortic valve replacement differ in how the valve is reached, what kind of valve is implanted, and what recovery and follow-up involve. The British Heart Foundation describes TAVI, also called TAVR, as a catheter-based procedure that replaces the aortic valve. Surgical replacement typically involves opening the chest and using cardiopulmonary bypass.
The practical question for an overseas patient is therefore not 'Which is newer?' or 'Which is less invasive?' It is: which approach does a qualified heart team consider appropriate for this patient, and what information do they need to make that judgement? Guidelines from professional cardiac societies generally recommend that the choice be made by a multidisciplinary heart team rather than by a single clinician or by the patient alone. That team usually includes interventional cardiologists, cardiac surgeons, imaging specialists and others as needed.
This matters for planning because the two pathways have different implications for tests, hospital stay, recovery, medications and follow-up. If you arrive expecting TAVI and the heart team recommends surgery, your plans change. If you arrive expecting surgery and the team recommends TAVI, the same applies. The only reliable way to reduce that uncertainty is to have the clinical review completed before you commit to travel.
What the heart team needs to decide suitability
The heart team's recommendation depends on several categories of information. You do not need to know the answer in advance, but you should know what to ask the hospital to review.
First, valve anatomy and severity. Echocardiography is central. The team will want to know the valve area, gradient, degree of regurgitation, and whether the valve is bicuspid or has other features that affect procedural planning. They may also want cardiac CT for TAVI planning, and coronary angiography to assess whether coronary artery disease also needs treatment.
Second, the rest of your heart and general health. Ejection fraction, pulmonary pressures, rhythm, kidney function, lung disease, previous chest surgery, frailty and other conditions all influence which approach is safer for you. A patient with severe lung disease or a previous bypass may be considered differently from a patient with few other conditions.
Third, your preferences and circumstances. How do you weigh a shorter initial recovery against the possibility of a future reintervention? What follow-up can you realistically attend? Are you able to take and monitor anticoagulation or antiplatelet medication? These are not minor details; they are part of the decision.
Ask the hospital directly: 'Will my case be discussed by a heart team, and can I receive a written summary of the recommendation and the reasons?' If the answer is vague, that is useful information about how to proceed.
Records to prepare before asking for a review
You do not need to send a complete archive at first contact. A brief summary is enough to start. But for a meaningful clinical review, the hospital will need specific documents. Ask what format they accept and whether they need original images or reports.
Useful items typically include recent echocardiography reports and images, cardiac CT if already done, coronary angiography reports, ECG, chest X-ray, blood tests including kidney function and blood count, a list of current medications with doses, and a summary of other medical conditions. If you have had previous heart surgery, the operative report is relevant. If you have a pacemaker or other device, include that information.
Do not assume that a report from your home country is automatically sufficient. Ask whether the hospital wants the original imaging on disc, a translated summary, or both. Ask who is responsible for translation and whether there is a fee. These are practical questions that affect timing.
One common planning mistake is to send a large file without a clear question. A short cover note stating your main concern, your current symptoms, and what you want to know is more useful than a disorganised archive. The hospital can then request what is missing.
Questions that change the next step
Some questions are generic. Others directly change what you do next. The following are worth asking in writing, so you have a record.
Ask: 'Based on the records I have sent, is my case suitable for review, and what additional information do you need?' This clarifies whether you are in a queue for clinical assessment or simply in a general enquiry process.
Ask: 'If the heart team recommends TAVI, what valve types and sizes are available at your hospital for my anatomy?' Device availability is not universal, and it can affect both suitability and scheduling. Do not assume that every approved device is available at every hospital.
Ask: 'If the heart team recommends surgery, what type of valve would be used, and what does follow-up involve?' Mechanical and biological valves have different implications for anticoagulation and durability. The choice depends on age, other conditions and patient preference.
Ask: 'What is the expected hospital stay, and what factors could extend it?' You should not expect a fixed number. The answer depends on the approach, your recovery and complications. But knowing the range the team plans for helps you arrange travel and accommodation.
Ask: 'What follow-up is required after discharge, and can any of it be done locally?' This is particularly important for overseas patients. Some follow-up can be coordinated with your local cardiologist; some may require a return visit. Clarify this before you travel.
Ask: 'What is the total estimated cost scope, and what does the written quote include or exclude?' Do not rely on verbal estimates. Request a written breakdown that distinguishes hospital fees, device costs, professional fees, and any coordination fees. Ask specifically about items that are undecided until the procedure is planned.
A planning example: two patients, two different pathways
Consider two hypothetical overseas patients, both with severe aortic stenosis. Patient A is 82, has had a previous coronary bypass, has chronic kidney disease and poor mobility. Patient B is 58, has no previous cardiac surgery, has good kidney function and no other major conditions, and is concerned about the durability of a tissue valve.
For Patient A, the heart team might consider TAVI because reoperative surgery carries higher risk. But that is not automatic. The team would still review valve anatomy, access vessels, and other factors. For Patient B, surgery might be preferred because of age and valve durability considerations, but again the team would review the full picture.
The point of this example is not to suggest what any individual should choose. It is to show that the same diagnosis can lead to different recommendations, and that the recommendation depends on information that only a clinical review can assess. Your job as a patient is to make sure that review happens before you commit to travel, and that you understand the reasoning.
What to confirm before travelling to China
Once a hospital has reviewed your records and offered a provisional plan, several things still need confirmation. Ask for them in writing.
Confirm that the hospital has accepted your case for treatment, not just for consultation. An appointment for assessment is not the same as an agreement to perform a procedure. Ask what steps remain before a treatment date can be set.
Confirm the proposed procedure, the intended valve type, and who will make the final decision if findings during the procedure differ from the plan. Ask whether a surgical backup is available if TAVI is planned, and vice versa.
Confirm the practical arrangements: how many days you should plan to be in China before and after the procedure, what medications you should continue or stop, and what follow-up is arranged. Do not rely on general timelines from other patients or websites. Your own plan depends on your clinical situation and the hospital's schedule.
Confirm what happens if you become unwell before travel. Worsening symptoms such as chest pain, breathlessness at rest, fainting or palpitations require urgent local assessment, not a delayed overseas trip. Your treating clinicians should advise you on this.
Finally, confirm the financial and administrative steps. Ask for a written quote, a list of what is included and excluded, and the payment process. Ask whether a deposit is required and what the refund policy is. These are business questions, not clinical ones, but they affect your planning.
Next step
If you are considering aortic valve replacement in China, start with a brief summary of your diagnosis, main symptoms and current question. An initial enquiry is free and does not require buying a proxy consultation. The hospital's heart team will decide whether TAVI, surgical replacement or another approach is suitable for you. Your next step is to ask what records they need and how the review will be conducted.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.