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Transcatheter aortic valve implantation - the decision, not just the procedure.

TAVI is a minimally invasive way to replace a diseased aortic valve through a catheter, avoiding open-heart surgery. This page focuses on the decision - who is a candidate, what a UK heart team weighs up, and how to compare TAVI to surgical replacement or watchful waiting.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private TAVI costs in the UK.

Indicative ranges across UK units.

In short

£40,000–£55,000 all-inclusive, home in 2–3 days.

Procedure Indicative range
TAVI heart team assessment package £1,800–£3,000
Gated cardiac CT for TAVI planning £900–£1,600
Transoesophageal echo (TOE) £1,200–£2,000
TAVI procedure (all-inclusive) £40,000–£55,000
Balloon aortic valvuloplasty (bridging) £7,500–£12,000
Cardiac rehab programme £600–£1,200
Interventional cardiology consultation only £300–£500

Prices vary by centre, valve type, whether cerebral embolic protection is used and length of stay. Follow-up echoes and cardiac rehab are usually itemised.

The problem

A decision, not just a procedure.

TAVI is where UK cardiology is at its best, but only when the decision is made properly - with a surgeon in the room, with frailty scored, and with the alternatives shown.

  • Was a surgeon in the meeting?

    A heart team without a cardiothoracic surgeon is not a heart team.

  • Have you been frailty-scored?

    A five-metre walk and a grip test tell you more than an echo about how you will do afterwards. Both are expected.

  • When is waiting the right answer?

    Asymptomatic severe AS with normal function is a surveillance case, not a valve. Watchful waiting remains a valid answer.

When it helps

When TAVI is the right step.

The situations that come up most, plus the one presentation - syncope or heart failure with severe AS - that means a same-week heart team, not routine planning.

  • Severe symptomatic aortic stenosis

    Breathlessness, chest tightness or syncope with a mean gradient over 40 mmHg or valve area under 1 cm² - the classic TAVI candidate.

  • Older or frail patient

    Over 75, or with meaningful frailty or comorbidity that makes surgical replacement higher risk.

  • Prior cardiac surgery

    A previous CABG or valve operation makes redo sternotomy technically hard - TAVI is often a better fit.

  • Failing bioprosthetic valve (valve-in-valve)

    A degenerated surgical bioprosthesis in a patient not fit for redo surgery - valve-in-valve TAVI is well established.

  • Middle age with high surgical risk

    A younger patient with severe comorbidity where surgery is high risk - TAVI may still win, with careful durability discussion.

  • Symptoms disproportionate to imaging

    Where symptoms are severe but numbers are borderline - dobutamine stress echo and a TAVI-experienced team can settle the case.

  • Patient preference for less-invasive

    Where surgery is possible but the patient values shorter recovery and no sternotomy - discussed openly, not dismissed.

  • Red flag: syncope or heart failure

    New collapse, resting breathlessness or hospitalisation for heart failure with severe AS is high-priority - same-week heart team, not routine wait.

Procedure options

Valve choice, access route, and the alternatives.

What each option involves - balloon-expandable or self-expanding valve, the access route, and when watchful waiting, valvuloplasty or surgical AVR is the better answer.

  • Balloon-expandable valve

    A cobalt-chromium frame with a bovine pericardial valve, mounted on a balloon and expanded in place. Precise deployment, well suited to heavily calcified annuli.

  • Self-expanding valve

    A nitinol frame with a porcine pericardial valve that opens as it warms. Suits certain annulus shapes and small aortas; recapturable partway through deployment.

  • Transfemoral access

    The default in the UK - a small puncture in the groin, closed with a suture device. No incision, day-of mobilisation.

  • Alternative access (subclavian, transcaval, transapical)

    Reserved for patients with unusable femoral vessels. Fewer of these are done as delivery sheaths get smaller.

  • Valve-in-valve TAVI

    A new transcatheter valve placed inside a failed surgical bioprosthesis - avoids redo sternotomy in high-risk patients.

  • Balloon aortic valvuloplasty

    A bridging procedure that stretches the diseased valve to buy weeks or months, used while the heart team decides or while other health issues are treated.

  • Watchful waiting

    For asymptomatic severe AS with normal LV function, careful surveillance every 3–6 months is often the right answer - not a valve.

  • Surgical AVR (SAVR)

    Open sternotomy or minimally invasive access, mechanical or bioprosthetic valve. Better durability data at very long follow-up - covered on the separate TAVR technology comparison page and heart valve surgery page.

Safety and recovery

What to expect afterwards - honestly.

TAVI is now a mature UK procedure, but stroke, pacemaker and paravalvular leak still matter - and every risk deserves an honest number, not a shrug.

  • Sedation or light GA in a hybrid theatre

    Most UK TAVIs are done under conscious sedation with local anaesthetic at the groin. GA is reserved for alternative access or complex anatomy.

  • Stroke

    Peri-procedural stroke rate has fallen with newer valves and technique - around 2–3% in modern UK series. Cerebral embolic protection is used in selected cases.

  • Vascular access complications

    Bleeding, dissection or false aneurysm at the femoral site occur in a few percent - usually managed at the same sitting with a covered stent or a small surgical repair.

  • New pacemaker

    Damage to the conduction system near the valve leads to a permanent pacemaker in around 10–15% of self-expanding cases and 5–10% of balloon-expandable cases.

  • Paravalvular leak

    Small residual leak around the valve is common early on. Moderate or worse leak affects outcomes and needs a plan - modern valves have made this uncommon.

  • Kidney injury

    Contrast used in planning CT and the procedure itself can affect kidney function - hydration and low-volume protocols reduce the risk.

  • Long-term valve durability

    Ten-year data now exist for balloon-expandable valves and are reassuring. Durability past 15 years is still being defined - it matters more the younger you are.

  • Anticoagulation and antiplatelets

    Antiplatelet, DOAC or warfarin depending on rhythm, stents and access site - the plan is written on your discharge letter.

  • Red flags after discharge

    New severe breathlessness, syncope, groin swelling or spreading redness, or new stroke symptoms need same-day cardiology or A&E.

Reading your notes

Your notes in four parts. Read the last one first.

Whichever valve was used, the note the interventional cardiologist writes keeps to the same shape.

  1. 01 Header

    Access and valve choice

    Which vessel was used, valve type and size, sedation or GA, and whether cerebral embolic protection was in place.

  2. 02 Technique

    Deployment and result

    Valve position, any post-dilation, presence and grade of any paravalvular leak, and coronary perfusion checked.

  3. 03 Findings

    Rhythm and echo on day one

    New conduction changes, whether a pacemaker was needed, and the day-one echo confirming valve function.

  4. 04 Impression

    Follow-up plan and medication

    Read this first: antiplatelet or anticoagulation, statin, pacemaker plan if any, and dates for 30-day, three-month and yearly review.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

TAVI is usually covered when severe symptomatic AS is confirmed and the heart team has recommended it in preference to surgery. Pre-authorisation is always needed.

Frequently asked

Common questions about the TAVI decision.

Quick answers on approach, recovery, cost and long-term outcome.

  • Am I a candidate for TAVI?

    Severe aortic stenosis with symptoms is the starting point. Beyond that, a UK heart team weighs your age, frailty, comorbidities, coronary anatomy, aortic valve annulus and femoral access. TAVI is well established for older or higher-risk patients and is increasingly offered to lower-risk patients, but the decision is always made together with a cardiothoracic surgeon present, not by a cardiologist alone.

  • TAVI or surgical AVR - which is better?

    It depends on age, risk and valve life. For older or higher-risk patients TAVI is at least as good as surgery for two-, five- and now ten-year outcomes. For younger, lower-risk patients, surgical AVR still has more long-term durability data. The right answer comes from a heart team, with a surgeon at the table.

  • How long is recovery from TAVI?

    Home in 48–72 hours for most patients. Back to gentle daily activities in a week. Cardiac rehab starts around week two and runs six to eight weeks. Most people notice their breathlessness improving within days of the procedure.

  • How much does a private TAVI cost in the UK?

    Roughly £40,000–£55,000 all-inclusive for the procedure and hospital stay, plus £1,800–£3,000 for the heart team assessment package (CT, echo, angiography, MDT clinic). Balloon aortic valvuloplasty as a bridge is £7,500–£12,000. Cardiac rehab is £600–£1,200.

  • Will I need a pacemaker afterwards?

    About 5–15% of TAVI patients need a permanent pacemaker, depending on valve type, existing conduction disease and anatomy. Self-expanding valves have a higher rate. Your heart team can quote the number for your particular case before you decide.

  • What about the NHS?

    TAVI is offered on the NHS at every major cardiac centre. NHS pathways are appropriate for most patients but come with a wait. Private assessment gives faster access to the heart team, faster CT and echo, and a scheduled procedure date - with the same evidence base and the same guidance.

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