TAVI Before 65? New Data Revive the Debate Between Catheter and Surgical Valve Replacement
• Nearly 30% of aortic valve replacements in US patients younger than 65 are now performed with TAVI/TAVR instead of surgery.
• TAVI use in this younger age group increased rapidly between 2016 and 2020, then appeared to plateau afterward.
• Registry data suggest that many younger TAVI patients had comorbidities including prior stroke, dialysis dependence, bicuspid valves
(commonly seen in younger patients and considered more complex&challenging for TAVI), and other complex surgical anatomy.
• Future guidelines are still expected to favor SAVR below age 65 unless stronger long-term randomized TAVI data become available.
• The Ross procedure also showed increasing use in younger low-risk patients. It uses the patient’s own pulmonary valve to replace the diseased aortic valve, while the pulmonary valve is replaced with a cadaveric donor valve (homograft).
Source: TCTMD
Published: May 8, 2026
https://www.tctmd.com/news/