Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
English · Turkish
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Interventional Cardiology
Tavi (transcatheter aortic valve implantation)
What TAVI (transcatheter aortic valve implantation) is, how a new valve is delivered through an artery without open-heart surgery, which patients with aortic stenosis it suits, how it compares with surgical valve replacement, approximate costs in Turkey against the UK, US and Germany, recovery, risks and how to check a hospital.
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Verified surgeons for TAVI (Transcatheter Aortic Valve Implantation)
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
English · Turkish
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TAVI (transcatheter aortic valve implantation) in Turkey: what it is
TAVI (transcatheter aortic valve implantation), also called TAVR in the United States, is a way of replacing a narrowed aortic valve without opening the chest. In aortic stenosis the valve between the heart's main pumping chamber and the aorta becomes stiff and calcified, so the heart must work harder to push blood out. Over time this causes breathlessness, chest pain, fainting and, if untreated, heart failure. In TAVI a folded replacement valve is carried on a catheter, usually through an artery in the groin, to the diseased valve and expanded inside it, pushing the old leaflets aside. Heart centres in Turkey perform TAVI for patients assessed by a heart team.
This guide explains how TAVI works, who is suitable, what the evidence says about durability, what it costs compared with the UK, US and Germany, and how to choose a hospital. It is a major heart procedure, so it begins with a specialist assessment, not a price. See also our overview of cardiology treatments in Turkey.
Who needs a TAVI, and what is aortic stenosis?
Aortic stenosis is mostly caused by age-related calcium build-up, sometimes by a congenital bicuspid valve or earlier rheumatic disease. Mild disease is monitored with ultrasound. Treatment is usually advised when stenosis is severe and causes symptoms such as breathlessness on effort, chest tightness, dizziness or blackouts, or when the heart muscle begins to be affected. No medicine can open a narrowed valve; tablets only ease symptoms. The only effective treatments replace the valve, either by open-heart surgery or by TAVI. Our guide to replacement of the aortic valve describes the surgical route in more detail.
How does TAVI work, step by step?
Before the procedure you have an echocardiogram, a CT scan of the valve, heart and access arteries, and usually a coronary angiogram, so that the team can choose the valve type and size and the safest access route. On the day:
- You receive local anaesthesia with sedation, or occasionally general anaesthesia.
- A catheter is inserted into the femoral artery in the groin (other routes exist when this is unsuitable) and guided to the aortic valve under X-ray.
- The new valve, made of animal tissue on a metal frame, is expanded either by a balloon or by its own self-expanding frame.
- The team checks the valve position and leakage with imaging, then removes the catheter and closes the artery.
The procedure takes roughly one to two hours. Most people are awake or lightly sedated and move to a monitored ward afterwards.
Does TAVI work? What does the evidence say?
Large trials have compared TAVI with open surgery and found outcomes at least comparable for older patients and those at higher surgical risk, with faster recovery after TAVI. European and American cardiology guidelines now recommend TAVI for many older patients, and a surgical valve for younger and lower-risk patients, with the choice made by a heart team of cardiologists and surgeons. The main open question is long-term durability: surgical valves have decades of follow-up, whereas TAVI follow-up in younger, lower-risk patients is still accumulating. A clinic that says one route suits everyone is oversimplifying; the right route depends on your age, anatomy, other illnesses and what you want.
TAVI cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges, not hospital quotes. In the UK and Germany TAVI is normally funded by the health system for eligible residents; the ranges show private or international patient prices. They depend on the valve (the device is the largest part of the cost), the access route, anaesthesia, intensive-care days and complications. Each hospital confirms its own price in a written quote.
| Country | Approximate cost range |
|---|---|
| Turkey | €15,000 – €35,000 |
| United Kingdom | €25,000 – €45,000 |
| United States | €40,000 – €90,000 |
| Germany | €25,000 – €45,000 |
A package normally covers pre-procedure imaging, the valve, the operating team, a stay in intensive care and on the ward, medication and transfers. Ask which valve brand is used, what is included if a pacemaker or vascular repair is needed, and what the price is if you must stay longer.
TAVI, open-heart surgery or balloon valvuloplasty: how do they compare?
All three treat a narrowed aortic valve, but they differ in invasiveness and durability. Open surgical replacement requires opening the chest and a heart-lung machine; it has the longest follow-up record. Balloon valvuloplasty stretches the valve without replacing it and is mostly a temporary measure. See also our general guide to heart valve replacement.
| Option | Best suited to | Typical limits |
|---|---|---|
| TAVI | Older patients and those at higher surgical risk with severe stenosis | Long-term durability data shorter; pacemaker or leak may occur |
| Surgical valve replacement | Younger or lower-risk patients, or when other heart surgery is needed | Major surgery; longer hospital stay and recovery |
| Balloon valvuloplasty | Bridging in very ill patients or children | Valve narrows again, often within months |
Who is a good candidate for TAVI, and who is not?
The heart team weighs age, symptoms, frailty, kidney and lung function, the shape of the valve and the arteries, and whether you also need bypass surgery. TAVI is more suitable when surgery would carry a higher risk, when the access arteries are of adequate size and when a bicuspid valve or heavy calcification are not too complex. It is usually not advised for a mild or moderate stenosis, for active infection of the heart (endocarditis), or when life expectancy is very limited by other illness. Coronary disease can often be treated in the same admission; see coronary stenting.
Your trip to Turkey and TAVI recovery
Most patients without complications stay in hospital two to five days and then remain in Turkey for about 7 to 10 days in total, so that the team can check the groin, rhythm and valve by echocardiogram before the flight. Many people walk the day after the procedure. Expect bruising at the access site and tiredness for a week or two. Light daily activity is usually fine within days; heavy lifting and strenuous exercise are avoided for around a month, as advised. You will take blood-thinning medication for a period set by the cardiologist, and need antibiotics before dental work in future. Flying is decided case by case; the team checks that you are stable first. A follow-up scan at around one month and then yearly is standard, and your own cardiologist at home should receive the reports.
Risks and complications of TAVI
TAVI is safer than the alternative of leaving severe symptomatic stenosis untreated, but it is not risk-free. Possible problems include bleeding or damage to the access artery, stroke or mini-stroke, kidney injury from contrast dye, leakage around the valve (paravalvular leak), a need for a permanent pacemaker because the valve presses on the heart's electrical pathway, infection and, rarely, damage to the heart or aorta that needs emergency surgery or leads to death. How likely each is depends on your age and health. The NHS, the British Heart Foundation and the American Heart Association all stress that TAVI should be recommended by a multidisciplinary heart team. Ask for your own estimated risk, not an average.
How do I choose a hospital for TAVI, and what are the red flags?
Choose a hospital with a dedicated heart team (interventional cardiologist and cardiac surgeon), cardiac surgery on site in case of emergency, cardiac intensive care and a TAVI programme that performs the procedure regularly. Ask to see the CT-based plan and which valve will be used. Red flags include a price quoted without any review of your scans, no mention of the heart-team decision, promises that you will be "cured" and pressure to travel quickly. Read how our process works and request a plan through our free quote page: the hospital reviews your echocardiogram and reports and sends a written plan and price.
What should I ask the clinic about TAVI?
- Has the heart team reviewed my scans, and is TAVI or surgery recommended for me?
- Which valve will be used, and what is its follow-up record?
- Is cardiac surgery available on site if something goes wrong?
- What is included if I need a pacemaker, a longer stay or a vascular repair?
- Who will monitor my valve once I am home, and will the reports be sent to my own cardiologist?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
TAVI replaces a narrowed aortic valve without open-heart surgery. A new valve is delivered on a catheter, usually through the groin artery, and expanded inside the old valve to restore blood flow.
Approximate ranges are €15,000 to €35,000 in Turkey, against about €25,000 to €45,000 in the UK for private patients. The valve device is the largest cost; the hospital confirms the price in a written quote.
Neither is right for everyone. TAVI has a quicker recovery and suits older or higher-risk patients; surgery has longer follow-up and often suits younger patients. A heart team should decide.
Follow-up data run for many years but are shorter than for surgical valves, especially in younger patients. Regular echocardiograms check the valve, and durability depends on valve type and the patient.
Most people stay two to five days in hospital and walk the day after. Light activity resumes within days, and heavy exertion is avoided for about a month, according to the cardiologist's advice.
It is done under local anaesthesia with sedation, or occasionally general anaesthesia. Afterwards there may be bruising and soreness at the groin, usually settled with simple painkillers.
Patients with mild or moderate stenosis, active heart infection, unsuitable access arteries or very limited life expectancy from other illness may not be suitable. The heart team decides after scans.
Risks include bleeding, vascular injury, stroke, kidney injury, valve leakage, a need for a pacemaker and, rarely, emergency surgery. Your own risk depends on age, anatomy and other illnesses.
Usually yes, once the team has checked the groin, rhythm and valve, often after 7 to 10 days. The cardiologist decides case by case and may advise walking and drinking fluids on the flight.
Plan about 7 to 10 days in total: pre-procedure imaging, the implantation, a hospital stay of two to five days and a check by echocardiogram before you travel home.
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