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Aortic Regurgitation Treatment: Surgical vs. Transcatheter Techniques

Written By: Allison DeMajistre, BSN, RN, CCRN
Medical Expert: William Brinkman, MD, Director, Thoracic Aortic Clinic, Baylor, Scott & White, The Heart Hospital-Plano, Plano, Texas
Reviewed By: Adam Pick, Patient Advocate, Author & Website Founder
Published: October 19, 2026

Transcatheter aortic valve replacement (TAVR) was recently approved to treat aortic valve regurgitation. It can be a game-changing procedure for older patients who may not be able to withstand surgical repair or replacement. It’s less invasive, has a shorter recovery time, and carries minimal risk. However, younger patients also develop aortic regurgitation from congenital heart defects, connective tissue disorders, or infections. For these patients, surgically repairing the aortic valve rather than replacing it may be a better option.

Adam Pick, founder of HeartValveSurgery.com, spoke with Dr. Bill Brinkman to learn more about techniques for managing aortic valve regurgitation. Dr. Brinkman is the Director of the Thoracic Aortic Clinic at Baylor Scott & White, The Heart Hospital-Plano in Plano, Texas. He has performed over 3,500 cardiac surgeries and specializes in aortic valve repair, the Ross Procedure, and aortic valve-sparing techniques.

Facts About Surgical vs. Transcatheter Techniques for Aortic Valve Regurgitation

Here are the key insights shared by Dr. Brinkman:

TAVR as a newly approved treatment for aortic regurgitation compared to surgical valve repair. “Having an additional tool to treat aortic insufficiency is great,” Dr. Brinkman said. “My only concern is that patients realize that sometimes their valves can be repaired.” He explained that repairing the leaflets, especially in younger patients, can often be a better solution than a TAVR since the replacement valve will most likely wear out in eight to 12 years. “I think younger patients, especially those with dilated aortas, can have their valve repaired with a re-implantation or remodeling technique. In older patients who are high risk for surgery, having the option to use TAVR for aortic insufficiency will really help people, but we need to be careful when using it for low-risk, younger patients.”
Advice for patients considering either transcatheter or surgical treatment for aortic valve regurgitation. Dr. Brinkman said, “My advice for younger patients, especially those with a mildly dilated aorta, is to have the valve repaired. It may be a better long-term solution than a TAVR valve that is guaranteed to wear out in a specific amount of time. Cardiologists often don’t know what surgeons can and can’t do when it comes to valve repair because they don’t work in a center that does it. I think it’s important to get a second opinion from a surgeon who can repair the valve before deciding.”

Thanks, Dr. Brinkman and Baylor, Scott & White!

On behalf of all the patients in our community, thank you, Dr. Bill Brinkman, for everything you and your team are doing at Baylor Scott & White The Heart Hospital- Plano in Plano, Texas.

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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Video Transcript:

Adam Pick: Hi everybody, it's Adam with HeartValveSurgery.com, and we're at the American Association for Thoracic Surgery meeting in Chicago, Illinois. I'm thrilled to be joined by Dr. Bill Brinkman, who is the director of the Thoracic Aortic Clinic at Baylor Scott & White, the Heart Hospital, Plano. Dr. Brinkman, it is great to see you again, and thanks for being with me today.

Dr. William Brinkman: I'm glad to be here. Thank you so much.

Adam Pick: We're here at AATS, and you and I were just having a great conversation about the treatment of aortic regurgitation.

There's several different techniques to manage that disease, and I'm curious to know, when you look at some of the newer techniques. Let's say for example TAVR, which has recently been approved for regurgitation, what are your thoughts on that?

Dr. William Brinkman: Having an additional tools to treat aortic insufficiency is great. My only concern is that patients realize that sometimes their valves can be repaired. And if you have your own living leaflets that are intended by nature to be leaflets, especially in younger patients, that might be a better situation than just putting in a TAVR valve that's gonna probably wear out in eight to 12 years.

So, I think in younger patients who have, especially the ones who have dilated aortas also, we need to realize that many times those valves can be repaired with a technique such as re-implantation or remodeling. I think in older patients who are at high risk for surgery, the use of TAVR valves for aortic insufficiency is going to really help people.

But we need to be careful in applying them in low-risk, younger patients.

Adam Pick: I have to ask you, what is your advice for patients when they have these considerations about transcatheter or surgical specific to aortic

Dr. William Brinkman: Well, my advice would be, if you're a younger patient, especially if your aorta is mildly dilated repair of those valves can be done and may be a better long-term solution for you as opposed to a valve that's guaranteed to wear out in a specific amount of time, like a TAVR valve.

Many cardiologists sometimes don't know what surgeons can and can't do in that area of repairing valves because they're just not working in a center that does that. So I think it's important to consider getting a second opinion from a surgeon who might be able to repair your valve, and just see what you think. What do you want?

Adam Pick: On behalf of the patients, thanks to you and your team at Baylor Scott & White, The Heart Hospital Plano, for everything you do.

Dr. William Brinkman: Thanks for the opportunity.

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