TAVR vs Surgery at 75: How the Heart Team Made the Decision.
An active 75-year-old golfer needed an aortic valve. The choice between TAVR and surgery was not straightforward.
This is a composite narrative based on common clinical scenarios. Patient details have been anonymized and combined for educational purposes. Individual results vary based on specific clinical circumstances.
A 75-year-old retired businessman from Florida was diagnosed with severe aortic stenosis after experiencing shortness of breath on the golf course. His local cardiologist recommended TAVR, while a surgeon he consulted suggested surgical aortic valve replacement. Confused by conflicting recommendations, he sought a Heart Team evaluation.
What our Heart Team found.
Our Heart Team review considered his anatomy, comorbidities, activity level, and life expectancy. His STS score was 2.1% (low risk). CT imaging showed favorable anatomy for either approach. However, his bicuspid valve morphology introduced a consideration: while TAVR is FDA-approved for bicuspid valves, surgical replacement offers more reliable results in this anatomy. His active lifestyle and 15+ year life expectancy favored a durable solution.
What happened next.
The Heart Team recommended surgical AVR with a bioprosthetic valve, acknowledging that TAVR was a reasonable alternative but that the bicuspid anatomy and expected longevity favored surgery. He underwent successful minimally invasive AVR and returned to golf within 6 weeks.
The TAVR vs surgery decision is not simply about age — it requires careful evaluation of anatomy, valve morphology, life expectancy, and patient preferences. The Heart Team approach ensures both perspectives are considered.
