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Doctor Q&A: What Patients Should Know About TAVR for Severe Symptomatic Aortic Stenosis

Written By: Allison DeMajistre, BSN, RN, CCRN
Medical Expert: Pranothi Hiremath, MD, Interventional Cardiologist
Reviewed By: Adam Pick, Patient Advocate, Author & Website Founder
Published: November 2, 2026

For patients diagnosed with severe symptomatic aortic stenosis, understanding treatment options can feel overwhelming. In the past, open-heart surgery was the primary way to replace a diseased aortic valve. Today, many patients may also be candidates for transcatheter aortic valve replacement, commonly known as TAVR.

In a recent interview with HeartValveSurgery.com, Dr. Pranoti Hiremath, an interventional and structural cardiologist at PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Oregon, shared important insights about TAVR, severe aortic stenosis, valve durability, and the role of the heart team. Dr. Hiremath has performed more than 1,000 cardiac interventions, including 500 TAVR procedures, and works closely with cardiac surgeons to help patients evaluate their best treatment options.

Key Findings from the Interview with Dr. Hiremath

1. TAVR is a minimally invasive way to replace the aortic valve.

TAVR stands for transcatheter aortic valve replacement. According to Dr. Hiremath, the replacement valve is placed inside a delivery system that is about the size of a pen. That delivery system is typically guided through a blood vessel in the leg or another access point in the body until it reaches the heart. Once there, the new valve can be placed inside the diseased aortic valve.

2. TAVR may offer important recovery benefits for patients.

One of the major advantages of TAVR is that it does not require open-heart surgery. Dr. Hiremath explained that patients do not need an incision through the breastbone, and they do not need to be placed on a heart-lung machine. Many TAVR patients also have shorter hospital stays, with recovery often requiring just one overnight stay instead of several days in the hospital.

Benefits may vary for some patients, the TAVR procedure risks may outweigh the benefits.

Common TAVR Advantages by Dr. Pranoti Hiremath

3. Many TAVR procedures are performed with limited sedation.

Dr. Hiremath noted that most TAVR procedures are performed with limited sedation. This means that many patients are breathing on their own during the procedure rather than requiring more intensive breathing support. For appropriate patients, this can help make the overall procedure and recovery easier.

TAVR risks may include, but are not limited to death, stroke, damage to the arteries, bleeding, and need for permanent pacemaker.

4. TAVR is now being considered for more types of patients.

When TAVR was first introduced, it was mainly used for patients who were too high-risk for open-heart surgery. However, Dr. Hiremath explained that the use of TAVR has expanded in recent years. Today, TAVR may be considered for patients at high, intermediate, and low risk for open-heart surgery, depending on their anatomy, health status, and the recommendation of the heart team^1-3.

5. The heart team plays a critical role in treatment decisions.

Dr. Hiremath emphasized that she works as part of a heart team, which includes both interventional cardiologists and open-heart surgeons. This team-based approach is important because every patient is different. Some patients may be better suited for TAVR, while others may benefit more from surgical aortic valve replacement or, in certain cases, a mechanical valve.

6. Valve durability and lifetime management are important considerations.

For many patients, one of the biggest questions is how long a replacement valve will last. Dr. Hiremath explained that patients and physicians should think carefully about valve durability and lifetime management. The goal is to choose a treatment strategy that helps patients get to the next stage of life while also considering what future treatment options may be needed.

7. Patients should not delay care after a severe aortic stenosis diagnosis.

Dr. Hiremath encouraged patients to stay connected with their medical team and move forward with care in a timely way. She noted that even patients with confirmed severe aortic stenosis who do not have many symptoms may benefit from earlier treatment with TAVR or surgical aortic valve replacement. As with any medical procedure, TAVR does have risks, including stroke, bleeding, and infection, so patients should discuss their individual risks and benefits with their care team.

The Patient Takeaway

Thanks to advances in heart valve therapy, patients with severe aortic stenosis now have more treatment options than ever before. For many patients, TAVR may provide a safe and effective alternative to open-heart surgery with a shorter recovery. However, the best treatment choice depends on each patient’s unique situation. By working with an experienced heart team, patients can better understand their options, ask the right questions, and move forward with greater confidence.

Benefits may vary, and for some patients, the TAVR procedure risks may outweigh the benefits.

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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Adam Pick: Hi everybody. It's Adam with HeartValveSurgery.com I am thrilled to be joined by Dr. Pranothi Hiremath who is an interventional and structural cardiologist at Peace Health, sacred Heart Medical Center, Riverbend in Springfield, Oregon. During her extraordinary career, Dr. Hiremath has performed over a thousand cardiac interventions, including 500 TAVRs. It is great to see you and thanks so much for being with me today.

Dr. Pranothi Hiremath: Thanks for having me, Adam.

Adam Pick: For the patients, can you share with them what your role is in the heart team specific to heart valve disease and more specifically aortic stenosis?

Dr. Pranothi Hiremath: I am a interventional and structural cardiologist, and I'm a member of the heart team along with the open heart surgeon. What this means is that I've trained in medicine and general cardiology subsequently with an emphasis on procedures and interventional cardiology, and a focus on valvular heart disease, including aortic stenosis, such that I now perform the transcatheter aortic valve replacements or TAVRs.

Adam Pick: Dr. Hiremath, thanks for your commitment to helping patients with aortic stenosis, using TAVR. Can you explain for the patients out there, what is TAVR?

Dr. Pranothi Hiremath: TAVR is transcatheter aortic valve replacement, and so around a decade ago, there was only one option, which was open heart surgery, and TAVR represents a second option. That's a minimally invasive approach to replacing the aortic valve The valve sits inside a delivery system that's around the size of a pen, and that can go into the leg vessels or other vessels of the body. And the valve replacement can then be performed . There are several advantages to the patient that make TAVR a favorable option for those undergoing TAVR.

There's no need for open heart surgery, so there's no incision in the sternum that requires healing. There's no heart and lung. Machine recovery is usually one night overnight rather than several days in the hospital. Most TAVRs are also performed with limited sedation, so the patient's breathing on their own and this makes the procedure safer.

Than those that require breathing support.

Adam Pick What type of patients is TAVR for?

Dr. Pranothi Hiremath: Initially, TAVR was limited to those patients who were too high risk for open heart surgery. in the last several years, the indications have actually expanded to include patients who are high, intermediate, and low risk for open heart surgery. This means that we see TAVR as an increasingly viable option for patients who are low risk for open heart surgery.

Both from the perspective of our recommendation as the heart team, but also from a patient preference perspective. TAVR is certainly an easier procedure to undergo, and in situations where the heart team thinks that either option is safe, it's increasingly reasonable for patients to choose TAVR as their option of choice because it's safe and effective in many cases.

Adam Pick: Dr. Hiremath, thanks for sharing about the considerations for SAVR and TAVR. Big question is long-term outcomes for these valves. What do you tell your patients when they come to you and they're thinking SAVR or TAVR and they're thinking out past 10 years?

Dr. Pranothi Hiremath: It's important for patients and their physicians as well to be thinking about valve durability and lifetime management. How can these valves get patients to the next stage of their lives and overall TAVR is showing robust clinical outcomes and strong valve performance as a good option to treat severe aortic. Stenosis, This is not to say that there is times when an anatomically a surgical valve may be a better choice or when a mechanical valve may be a better choice than a tissue valve.

But overall, for many patients, TAVR is an excellent, safe and effective option.

Dr. Pranothi Hiremath: Thanks for those points. And now I've gotta ask you, what is your advice for patients who are considering TAVR?

Dr. Pranothi Hiremath: I encourage patients to follow up with their medical team, find a team they trust, and to move forward with their care soon. What we know about the indications for aortic valve replacement is that even in those people with confirmed severe aortic stenosis without many symptoms, it's increasingly advantageous to perform TAVR or SAVR. Sooner in the process of disease progression. as with all medical procedures, there are some risks with TAVR stroke, bleeding, infection, But these are comparable between surgical and TAVR valves.

Adam Pick: That is fantastic advice, and on behalf of all the patients at HeartValveSurgery.com, patients all over the world, thanks so much to you and your team for everything you're doing specific to the treatment of Aortic stenosis with TAVR and SAVR. Thanks for being with me today.

Dr. Pranothi Hiremath: Thank you so much, Adam.

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