Hi
I'm also skeptical, and until I see it in the mainstream am uncertain that TAVR will be mainstream. I believe there are more complications to overcome than those of us in the general public grasp. I often draw on the analogy that we went to the moon in 1960's and now we still aren't there. Noone has thought through the valve in the valve in the valve well (you know, your third revalve via TAVI), yes I've seen some designs that may address this, but many issues remain unsolved (diameter being one)...
of course if it doesn't "take off" then there will be more redo surgeries to do if surgeons keep the preference on tissue as they are. To quote Master Yoda: "Difficult to see the future is".
Don't get me wrong, I am coming to the conclusion that managing INR is beyond most people and so it seems to me that Mechanica Valves are for the enthusiast who manages his or her health. There are amateur athletes who do more measurement and documentation on their weekly training , to such a person INR management is trival. However there are many others who managing even their contact list in their phone is beyond them. If the questions I see on the AC forum here are anything to go by I wonder if self management suits many older people at all... The real irony is that its the younger and more competent who perceive themselves as better off with a tissue prosthesis (perhaps dreaming of a TAVI).
Lastly I'm always skeptical of anything someone who is NOT facing the actual choice says when they say "I'd choose X" ... somehow being there at the cross roads makes it different. Maybe they would, maybe they would agnoize a bit more than they make out.