TAVR and TAVI in China: Communicating With Your Home Medical Team

Start with the two questions that shape everything else

Before any file moves, clarify what each side is being asked to do. Your home team is usually being asked to remain your longitudinal cardiology contact: to confirm your baseline, to state what has already been tried, and to receive the China team's plan and discharge information. The China heart team is being asked to assess whether a catheter-based aortic valve procedure is appropriate for you at all, which device configuration it would consider, and what admission and follow-up would involve.

Those are different tasks, and they need different records. A home cardiologist who is only asked to 'send everything' may send a discharge summary that omits the raw echocardiogram loops and the CT measurements the China team actually needs to review valve anatomy. A China hospital that receives only a translated summary may ask for the original files again, which costs time.

So write down two sentences before you contact anyone. First: 'My home team is asked to confirm my cardiac history and remain my follow-up contact.' Second: 'The China heart team is asked to review my valve imaging and advise whether TAVR or TAVI is suitable for me, and if so under what conditions.' If either sentence is wrong for your situation, correct it now rather than after records have been sent.

What the China heart team needs to see, and why the original matters

TAVI, also called TAVR, replaces the aortic valve using a catheter-based procedure. Whether that route is appropriate for a particular person is a heart team decision, not something a patient or a coordination service can settle in advance. The heart team's review depends on the quality of the imaging and measurements it receives, which is why the original files matter more than a typed summary.

Ask the China hospital, in writing, which items it wants. Typical requests in valve assessment include the echocardiogram report and the original image loops, the most recent CT of the heart and aorta if one exists, coronary angiography if performed, and the current medication list with doses. Ask specifically whether they want DICOM files on physical media or a secure download link, and whether they accept images in your home country's format.

Then ask your home team the mirror question: what can they release, in what format, and how long will it take? Some hospitals release imaging on request to the patient; others release it only to another clinician. Knowing this before you promise files to China prevents a gap where both sides believe the other is sending something.

One practical point: do not send a complete medical archive to a coordination service at first contact. A short summary of the diagnosis and the main question is enough to start. Detailed records should move through a route your home team has approved, once you know what the China team actually needs.

Build one shared question list instead of two separate conversations

A frequent failure in cross-border valve assessment is not missing records; it is two conversations that never meet. Your home cardiologist answers questions about your history. The China team answers questions about the procedure. Neither sees the other's answers, so contradictions surface late.

Keep a single document with numbered questions and space for both sides to answer. It travels with the records. Useful entries include: which valve measurements are borderline and why; whether the China team is considering a balloon-expandable or self-expanding device and what that choice depends on; what additional testing would be required in China before a final decision; what the proposed admission would involve; and what follow-up the China team recommends after discharge, including who should perform it.

Add one question that patients often forget: 'If my home team disagrees with the China assessment, what information would resolve the disagreement?' That question forces both sides to name the specific evidence rather than exchange opinions.

Keep the list short enough to be answered. Ten focused questions get answered; forty get skimmed.

• Which valve measurements are borderline, and what would change the assessment?
• Which device type is being considered, and what does that choice depend on?
• What tests would still be needed in China before a final decision?
• What does the proposed admission involve, and what is confirmed versus provisional?
• What follow-up does the China team recommend, and who should provide it?
• What information would resolve a disagreement between the two teams?

How to move records without losing the clinical thread

Records should move in one direction at a time, with confirmation at each step. Send the China team the imaging and reports it requested. Ask for written confirmation of what arrived and what is still missing. Then send the China team's assessment back to your home cardiologist, with the original imaging references intact so your home team can review the same source material.

Translation is where detail is most easily lost. If reports are translated, ask that the original-language version travel alongside the translation, and that measurements and dates are not rounded. A translated summary that says 'moderate stenosis' without the original numbers is much less useful than the numbers themselves.

Ask both sides how they prefer to communicate: secure email, a hospital portal, or a scheduled call. A scheduled call with a named clinician on each side is often more productive than a chain of messages, but it needs an agenda — your numbered question list serves that purpose.

If a step cannot be completed — your home hospital will not release imaging directly, or the China team needs a test that has not been done — say so explicitly to both sides rather than waiting. A stated gap is manageable. A silent gap is not.

What a reply confirms, and what it does not

A China heart team's written response to your records confirms that your file has been reviewed and states its current view. It does not confirm that you are accepted for treatment, that a specific device is available, that a particular date is reserved, or that the procedure will go ahead. Those are separate decisions made after in-person assessment, and they can change if new information emerges.

Similarly, your home cardiologist's agreement to remain your follow-up contact confirms willingness in principle. It does not confirm that your home hospital will accept the China team's plan, that reimbursement will follow, or that a specific follow-up appointment exists. Ask your home team what it needs in order to take over follow-up after you return, and get that in writing before you travel.

Treat every stage as provisional until the responsible clinician confirms it. Ask the China hospital which parts of the plan are confirmed and which are still subject to in-person assessment. Ask your home team the same question about follow-up. Where the two answers conflict, that conflict is itself useful information to resolve before committing to travel.

A practical order of actions, and what to do if a step stalls

Work in this order. First, agree the two roles with both teams. Second, ask the China hospital in writing which records and imaging it wants. Third, ask your home team what it can release and how. Fourth, send the records and confirm receipt. Fifth, send the China assessment back to your home team with the same source files. Sixth, agree the follow-up plan in writing before any travel decision.

If a step stalls, do not skip it. If your home hospital will not release imaging to a third party, ask whether it will release it directly to the China hospital, or to you as the patient. If the China team asks for a test that has not been done, ask whether it can be performed locally first and whether the result would change the assessment. If your home cardiologist is unavailable, ask the practice which colleague can review the file.

Urgent or worsening symptoms take priority over any overseas planning. New chest pain, breathlessness at rest, fainting or rapid deterioration need local emergency assessment, not an email to a China hospital.

ChinaSpecialistCare can help with non-clinical coordination: requesting a specialist appointment, arranging interpretation, and helping records reach the right department. Clinical assessment, suitability for TAVR or TAVI, device decisions and hospital acceptance remain with the treating heart team. An initial enquiry is free and does not require buying a proxy consultation; a short summary of the diagnosis and your main question is enough to begin.

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