Hi.
,he said he would do a Tavr or open heart
if anyone would like to share there thoughts on which way to go it would really help
Sure. If it were me and I was 85+ years old, I would choose TAVR in a heartbeat. I might also choose TAVR if I was 75 years old and in very poor health. But at 66, if it were me I would go SAVR. (surgical aortic valve replacement)
Here are the pros and cons as I see them:
TAVR advantages:
Lower mortality than SAVR in the first year after surgery.
Quick healing- back to resuming your normal activities in a matter of weeks.
TAVR disadvantages: Lack of data for lower risk patients. It is relatively unknown how long a TAVR will last for a 66 year old, but they are not expected to last as long as SAVR at this point, guided by the early data.
SAVR advantages:
Beter mortality than TAVR for years 2-5 following surgery. I expect that this trend will continue in years 6,7,8+, but data is lacking.
Good data on tissue valves lasting a long time for people 65+ years old. At age 66 this will very possibly be the last valve that you will ever need. Your surgeon indicated that he would use the Insprirs Resilia. This is the valve which I would go with if I was 66 and it is hopeful that it will do even better than the previous generation of tissue valves. Getting 15-20+ years out of this valve is realistic to hope for. Possibly even longer.
SAVR disadvantages:
Longer healing time and you will need to take more time to recover.
So, in my view, if I expected to live at least 3-5+ years, and at age 66 I sure hope that you do, I would personally choose to go with a surgical replacement over a TAVR.
I feel pretty comfortable with him as he says he has over 12,000.00 aortic valve replacements.
Excellent! You want as much experience as possible for the surgeon doing your procedure. It sounds like you are in great hands.
You may find this study of interest. It is a 2020 meta analysis comparing TAVR to SAVR, which looks at the 1 year, 2 -3 year and 5 year points, comparing the two procedures.
Conclusion:
"TAVR valves appear to be more susceptible to structural valve deterioration and thus potentially less structurally durable than SAVR valves, given that they may be associated with higher rates of moderate or severe aortic regurgitation, paravalvular regurgitation and reintervention in the 1-year-, 2–3 year, and 5-year period."
https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-020-01170-7