What your existing tests already answered
When you arrive with a folder of echocardiograms, stress tests, coronary angiograms or CT scans, the first useful step is not to repeat everything. It is to separate what those records already establish from what remains genuinely open. An echocardiogram typically reports the aortic valve area, the mean pressure gradient and the peak velocity. Those numbers answer whether the valve is significantly narrowed and how severe the narrowing is. A prior coronary angiogram answers whether there is coexisting coronary artery disease that might need attention at the same time. A stress test or a six-minute walk may show how your heart responds to exertion.
Those results do not, by themselves, tell a heart team whether a catheter-based procedure is the right route for you. They describe the problem. They do not describe the anatomy through which a device would have to travel or sit. That distinction is the reason a new assessment is not simply a repeat of what you already have. It is a different question asked of different imaging.
If your records are incomplete or from several years ago, that does not mean a clinician must guess. It means the receiving team needs to know which images exist, when they were taken and whether the original digital files, not just the reports, can be shared. Ask the hospital what it needs before it can comment on suitability.
What a new TAVR or TAVI assessment is actually asking
TAVI, also called TAVR, replaces the aortic valve using a catheter-based procedure. That single sentence contains the whole clinical question. A catheter-based route means the device is delivered through the blood vessels, such as the femoral artery in the groin, rather than through an open chest incision. Whether that route is possible depends on the size, shape and condition of your access vessels, the position and calcification of your aortic valve, and the relationship between the valve and the coronary arteries.
So a new assessment is not asking "is the valve narrow?" It is asking: can a device be delivered safely to this valve, anchored securely in this anatomy, without obstructing the coronary arteries, and is the expected benefit worth the procedural risk for this particular patient? Those are separate questions from the ones your previous tests answered.
The assessment also considers the whole patient, not just the valve. Frailty, kidney function, lung disease, previous cardiac surgery and other conditions all influence whether a catheter-based approach is preferable to surgical aortic valve replacement, or whether either is appropriate. This is why the decision is made by a heart team rather than by a single measurement.
Valve anatomy, access vessels and device selection
The imaging that answers these questions is different from a standard transthoracic echocardiogram. A gated CT angiogram of the heart and the access vessels is commonly used to measure the aortic annulus, assess the distribution of calcium, evaluate the distance from the valve to the coronary artery openings, and check the diameter and tortuosity of the femoral and iliac arteries. A transoesophageal echocardiogram may be used to look at the valve in more detail. These are not universal requirements for every patient, and the exact imaging a heart team requests depends on your case.
Device selection follows from that anatomy. Different valves have different profiles, deployment mechanisms and sizing ranges. A heart team may have access to several devices, or it may work primarily with one or two. Which devices are available at a particular hospital in China is a question to ask that hospital directly. It is not something that can be assumed from a foreign centre's practice or from a general statement about the procedure.
If your access vessels are too narrow, too tortuous or too calcified for a transfemoral approach, the team may consider alternative access routes. That is a clinical judgement based on your imaging, not a preference. Ask the heart team what access route they are considering for you and why.
The records and images worth sending first
A useful first enquiry does not require a complete medical archive. It requires enough for the receiving team to understand the question. The most helpful items are usually the most recent echocardiogram report and, if available, the original image files; any CT angiogram of the aorta and access vessels; the most recent coronary angiogram report; a list of your current medications with doses; a summary of other significant conditions; and a clear statement of your main question.
Reports alone are often not enough for a heart team to assess valve anatomy. The original DICOM files from CT and echocardiography allow the team to make its own measurements rather than relying on a summary. Ask the hospital whether it can accept image files in your format and how it prefers to receive them.
It also helps to say what you already know. If a cardiologist has already told you that surgery is high risk for you, or that your access vessels are difficult, that context is relevant. It does not bind the receiving team, but it tells them what has already been considered.
Questions that change the plan
The answers to a small number of questions determine whether a new assessment is worth arranging and what it would involve. Ask the heart team: based on the records I have sent, is there enough information to comment on whether a catheter-based approach is technically feasible for my valve anatomy? If not, what specific imaging would you need? Which access route are you considering, and what in my imaging supports that? Which device or devices would you consider, and are they available at your hospital? What would you need to confirm before you could give a written estimate of the hospital charges?
Ask also about the sequence. Would the assessment be completed in one visit or across several? Would any of the imaging need to be done at the hospital, or can outside images be used? If a hospital-based CT is needed, how is it scheduled? These are administrative questions with hospital-specific answers, not China-wide rules.
Finally, ask what the assessment does not cover. A records-based review can comment on anatomy and likely suitability. It cannot confirm final eligibility, because that depends on in-person examination, current test results and the heart team's collective judgement. It also cannot guarantee that a procedure will be offered or scheduled.
How to prepare and what to confirm next
If you are considering an assessment in China, start with a short summary rather than a full archive. Describe your valve diagnosis, the date and result of your most recent echocardiogram, any prior cardiac surgery or catheter procedures, your main symptoms and your main question. Mention which imaging files you have and in what format. That is enough for an initial review to identify what is missing and what the relevant next step would be.
Do not delay necessary local care while an overseas enquiry is in progress. If your symptoms are worsening, seek assessment where you are. A remote review is not emergency care and does not replace an in-person evaluation.
An initial enquiry through ChinaSpecialistCare is free and non-clinical. It checks the available diagnosis, records and your main question, identifies missing information and suggests the relevant next step. It is not a diagnosis and not a promise of acceptance. If a records-based specialist opinion is useful, that can be discussed separately, but it is optional and not a prerequisite for every appointment. The hospital and its heart team decide suitability, device choice and whether a procedure can be offered.
For a fuller picture of the procedure itself, including how the heart team reviews valve imaging and what admission and follow-up reviews involve for your case, see the TAVR and TAVI reference page.
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.