It appears that it's "slow" because you've been stuck in consideration/decision mode for several years. You have evaluated all options and potential locations. You need to execute the decision.The getting done is slow going here for two reasons
1) I have to pay for everything
2) Not sure where to get it done
Cost we have discussed. Your total out of pocket in Thailand is equivalent to deductibles in the US.
TAVR - Has your Dr. confirmed that you are a candidate? I wasn't.
I can't imagine you going thru this entire process again in 5 to 10 years if you go Bio on round 1.
Good luck!