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intermediate, high or prohibitive surgical risk","Severe aortic stenosis favored for transcatheter treatment by heart team","Degenerated bioprosthetic aortic valve (valve-in-valve) in selected patients"],"main_risks":["Stroke or transient ischemic attack","Vascular access complications and bleeding","Conduction disturbances requiring permanent pacemaker","Paravalvular leak","Acute kidney injury","Coronary obstruction, annular rupture (rare)","Valve thrombosis or later structural valve deterioration","Death (low but real periprocedural risk)","Endocarditis"],"pain":"Usually mild to moderate; groin access-site soreness and bruising for several days, managed with simple analgesics.","preparation":["Heart-team evaluation","Echocardiography, ECG and blood tests","Gated CT angiography of aorta, annulus and iliofemoral vessels","Coronary angiography as needed","Dental and infection screening","Fasting before the procedure as instructed","Review of medications by the care team","Informed consent"],"recovery_timeline":[{"phase":"Day 0–1","description":"Bed rest for a few hours after the procedure, rhythm monitoring, early mobilization.","restrictions":["Keep the access leg straight initially"]},{"phase":"Days 2–7","description":"Discharge in uncomplicated cases, walking, access-site care, monitoring for bleeding or rhythm problems.","restrictions":["No heavy lifting","No driving until cleared"]},{"phase":"Weeks 2–6","description":"Gradual return to normal activity; follow-up echocardiography.","restrictions":["Avoid strenuous exertion until cleared"]}],"rehabilitation_days":{"min":7,"max":21,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated transfemoral TAVI; cardiac rehabilitation, if used, is longer."},"result_longevity":"Durability data extend to roughly 5–10 years with generally acceptable valve function; long-term durability depends on valve type and patient factors, and is still being studied.","revision_rate_pct":{"min":1,"max":5,"unit":"percent","qualifier":"Repeat valve intervention or reintervention (e.g. valve-in-valve, surgery) within about 5 years; early reintervention under 1-2%."},"scars":"Transfemoral access leaves only a tiny puncture site in the groin, with minimal scarring; surgical cutdown, if needed, leaves a small incision.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single procedure."},"stages":[{"code":"valve_implantation","label":"Transcatheter valve implantation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on day of procedure."}}],"qualifier":"Single-stage transfemoral TAVI."},"success":{"metric":"Survival at 1 year after TAVI","value":92,"unit":"percent","horizon":"1 year","population":"Adults with symptomatic severe aortic stenosis, intermediate surgical risk, transfemoral TAVI","evidence_status":"proven"},"techniques":[{"name":"Transfemoral TAVI with balloon-expandable valve","suits_whom":"Most patients with suitable femoral vessels and aortic annulus anatomy.","recovery":"Discharge usually within 1–3 days."},{"name":"Transfemoral TAVI with self-expanding valve","suits_whom":"Patients with suitable anatomy, including some with small annulus or elevated risk of annular injury.","recovery":"Similar recovery; pacemaker need may be somewhat higher."},{"name":"Alternative access (transaxillary, transcarotid, transapical)","suits_whom":"Patients with unsuitable femoral vessels.","recovery":"Often longer recovery than transfemoral."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Procedure time for uncomplicated transfemoral TAVI; excludes preparation and recovery."},"initial_assessment_documents":["Recent transthoracic echocardiogram report","CT angiography report of aorta and femoral arteries","Coronary angiogram report","Recent ECG","List of blood thinners"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage procedure; stay about 7-10 days including pre-procedure tests, 1-3 nights in hospital and discharge checks. Later reviews done locally."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Expect two consultations with the treating surgeon before any surgery, which also gives you time to reconsider","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask whether a doctor is always present in the clinic and whether a high dependency or intensive care unit exists","scope":"treatment_abroad","source":{"url":"https://www.bapras.org.uk/public/patient-information/cosmetic-surgery/cosmetic-surgery-abroad","host":"bapras.org.uk","quote":"Is there always a doctor in the clinic and is there a high dependency or intensive care unit?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your other medical problems do not make the operation too risky","name":"Conventional open-heart surgery","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/cardiothoracic-services/cath-lab/information-about-the-tavi-procedure/","host":"newcastle-hospitals.nhs.uk","quote":"This surgery may not be suitable for all patients, especially where other medical problems make the operation too risky.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"You need treatment for fluid build-up in the heart and lungs","name":"Diuretic (water tablet) medication","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/cardiothoracic-services/cath-lab/information-about-the-tavi-procedure/","host":"newcastle-hospitals.nhs.uk","quote":"Medication , most often with diuretics (water tablets) which get rid of the fluid build-up in the heart and lungs.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"transfemoral-tavi-balloon-expandable","name":"Transfemoral TAVI with balloon-expandable valve","how_it_works":{"text":"The new valve is inserted through an artery in the leg","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/cardiothoracic-services/cath-lab/information-about-the-tavi-procedure/","host":"newcastle-hospitals.nhs.uk","quote":"The heart does not need to be stopped for this and, in the majority of cases, the new valve is inserted and moved into position through the artery via a small cut in the top of the leg.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":1,"unit":"weeks","label":"1 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