Aortic stenosis is narrowing of the aortic valve. Treatment decisions should start with confirmation of stenosis severity, symptoms, ventricular function, anatomy and overall health. When intervention is indicated, the Heart Team compares transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement rather than assuming that one procedure is automatically appropriate for every patient.
Confirm severity before choosing a procedure
Current European valvular-heart-disease guidance places echocardiography, clinical assessment and specialist Heart Team review at the center of aortic-stenosis management. Additional imaging or functional assessment may be needed when severity, symptoms or anatomy are not straightforward.
- Recent transthoracic echocardiography and valve measurements
- Symptoms such as exertional breathlessness, chest discomfort or fainting
- Left-ventricular function and other valve disease
- Coronary disease and major comorbidities
- CT or other imaging when planning an intervention
TAVI and surgical valve replacement are different pathways
TAVI is a catheter-based valve replacement, while surgical aortic valve replacement removes the diseased valve and implants a prosthesis during cardiac surgery. The choice depends on age, anatomy, procedural risk, vascular access, expected durability, coronary and aortic disease, previous surgery and patient preferences.
Why a Heart Valve Centre matters
The 2025 ESC/EACTS guidelines emphasize multidisciplinary Heart Teams and specialist Heart Valve Centres for complex decisions. A center that can evaluate both interventional and surgical options is better positioned to explain why one pathway is preferred in an individual case.
Records for an international review
Send enough information for the valve team to evaluate both disease severity and treatment options before travel.
- Recent echocardiography report and images when available
- ECG and cardiology summary
- CT, coronary angiography or other cardiac imaging already performed
- Previous cardiac surgery or intervention reports
- Current medication and relevant laboratory results
- Major kidney, lung, vascular or neurological conditions
Plan the full treatment episode
International patients should clarify whether additional diagnostics are needed in Germany, which intervention is being proposed, the expected hospital stay, medication changes, early follow-up and when long-distance travel home is considered reasonable.
Sources and review
This guide was last source-reviewed on 2026-08-31.