How risks for TAVI or TAVR, transcatheter aortic valve replacement procedure, differ from risks of open-heart surgery? Dr. Anton Titov, MD. What are the unique risks for the TAVI / TAVR procedures? Yes, that is such an important question. Because patients come to us all the time. They say this. Why can't I just have a TAVR? Is TAVI better or not? Dr. Anton Titov, MD. You can compare the TAVI / TAVR procedure and open heart surgery to replace aortic valve directly. Dr. Marc Pelletier, MD. We think that they are very comparable in some areas. In some areas TAVR is better than open heart surgery. In other areas replacing aortic valve by open heart surgery is better. I would say this. Dr. Marc Pelletier, MD. The two procedures appear to be quite similar in survival of patients. TAVI and open heart aortic valve replacement surgery are similar in survival of patients. That seems to be quite equal among the two. At least in the patients who are intermediate risk or higher risk for surgery results. Patients seem to have a fairly low mortality in both groups, TAVR and open surgery. The rates of brain stroke have been quite similar. Dr. Marc Pelletier, MD. Sometimes they are a little lower with TAVR. Sometimes they are a little higher with TAVR. TAVR and open heart aortic valve surgery are fairly equal in these side effects. TAVR wins out, it does much better than open aortic valve surgery in patient comfort and the patient experience. After TAVI / TAVR patients quickly recover from the procedure and get back to a meaningful life and a full recovery. Patients get back to work after after TAVR. Patients get back to their physical activities faster after TAVI. Dr. Marc Pelletier, MD. The scars and the incisions and the discomfort are much less with TAVR / TAVI. They are less than with open aortic valve replacement surgery. There is less chances of requiring a blood transfusion during the TAVI / TAVR procedure. Dr. Anton Titov, MD. There is less chance of atrial fibrillation. There are many good things that TAVR / TAVI offers patients with aortic stenosis. On the other hand, open heart surgery to replace aortic valve has advantages in some other areas. The aortic valve function is a little bit more predictable after surgery. After TAVR / TAVI some valves may leak a little. It is not a high percentage, 3% to 5%. But with surgery risk of aortic valve leak is about zero percent. Dr. Marc Pelletier, MD. With open surgery the durability of aortic valves is very well established. We think that those aortic heart valves last a long time. Dr. Marc Pelletier, MD. We don't yet know aortic valve durability with TAVR. We will find out as time goes on. The predictability of the operation is a little bit more standardized with an open surgery. It's done on a heart-lung machine. Entire operative field is in front of your eyes, everything is visible. Dr. Anton Titov, MD. A surgeon can control most aspects of that procedure. With TAVR, there's more unpredictability. There is an element when you lose control, or maybe not lose control. But when the aortic TAVR valve is going up, is it gonna go exactly at the right spot? Dr. Anton Titov, MD. How was the old valve going to react? How will the old valve interfere with the coronary arteries? There are many of those things that sometimes are unpredictable with TAVR. TAVI is harder to know. Dr. Marc Pelletier, MD. There are patients who are very low risk and are quite healthy. Which of the two procedures is better? Is TAVR better than open heart aortic valve replacement surgery? We don't have yet that answer. We will have the answer with some of the trials that are ongoing right now.