Aortic valve stenosis commonly occurs in older adults. Mild cases may cause shortness of breath, chest tightness, or angina, while severe cases may lead to heart failure. Relying solely on medication makes it difficult to reverse symptoms and may be fatal about 50% of patients die within two years. Surgery remains the fundamental solution.

Surgical Methods and Valve Selection
According to Dr. Shen Da-Zhong, Director of the Cardiovascular Surgery Department at Taipei Tzu Chi Hospital, valve stenosis is a structural disease, and medication can only relieve symptoms but cannot cure the condition. Surgical procedures are now well-developed and include traditional "open-chest surgery" and "transcatheter aortic valve replacement (TAVR)." Patients can discuss with their doctors to decide the most suitable treatment.

The valves used in surgery are divided into metallic mechanical valves and biological valves. Mechanical valves are highly durable, lasting 30 to 40 years, but require lifelong use of anticoagulants, which may increase the risk of bleeding. Biological valves, made from animal tissues, are more compatible with the human body and do not require anticoagulants, but their lifespan is only about 15 to 20 years, making them suitable for patients over 65 or those in high-risk occupations.Differences Between Traditional Open-Chest Surgery and Transcatheter Implantation (Image/Provided by Heho Health)

Transcatheter Surgery: Simple and Minimally Invasive
TAVR does not require open-chest surgery. Instead, a catheter is inserted through the groin, where the old valve is compressed against the vessel wall and replaced with a new valve. The procedure takes about one hour, with only a 4 cm incision. Most patients do not require general anesthesia, and recovery is fast.

Currently, Taiwan&rsquos National Health Insurance covers TAVR for patients with heart failure symptoms, confirmed severe valve stenosis, and if two specialists determine that traditional surgery is unsuitable. Additionally, the patient must be expected to survive for at least one year after surgery. Since July 2022, the previous age limit (over 80 years old) has been removed.

Challenges of Coexisting with the Condition and Future Outlook
Dr. Shen reminds that TAVR valve longevity is limited, and a second surgery may be required in the future. Therefore, lifelong treatment planning with a physician is necessary. As life expectancy increases, managing the condition in the long term becomes a key focus. Doctors and patients must work together to choose the most appropriate surgical approach for optimal treatment outcomes.Shen Da-Zhong, Director of the Cardiovascular Surgery Department at Taipei Tzu Chi Hospital (Image/Provided by Heho Health)