TAVI Procedure in Korea

At a Glance

Overview

Transcatheter Aortic Valve Implantation (TAVI) — also called TAVR — is a minimally invasive heart procedure that replaces a severely narrowed (stenotic) aortic valve without stopping the heart or opening the chest.

A compressed replacement valve is loaded onto a catheter, guided through the femoral artery (groin) or an alternative access site, positioned inside the diseased valve, and expanded. The old valve leaflets are pushed aside and the new valve begins functioning immediately.

TAVI was developed for patients considered too high-risk for conventional open-heart surgical aortic valve replacement (SAVR). Global evidence has since expanded its use to intermediate- and, increasingly, lower-risk patients with severe symptomatic aortic stenosis.

Aortic stenosis — the progressive calcification and narrowing of the aortic valve — is one of the most common serious heart valve diseases in adults over 65. Left untreated, severe symptomatic aortic stenosis carries a poor prognosis without intervention.

Key terms to know: - Aortic stenosis — narrowing that restricts blood flow from the heart - Transcatheter — delivered via a thin tube (catheter) through a blood vessel - MFDS — Korea's Ministry of Food and Drug Safety, which approves TAVI devices for clinical use in Korea

Am I a Candidate?

TAVI is primarily indicated for adults with severe symptomatic aortic stenosis who are at elevated surgical risk or who prefer to avoid open-chest surgery.

Candidacy centers on risk. Typical candidates are adults over 65 with calcific aortic stenosis and symptoms (chest pain, breathlessness, fainting), or patients with significant comorbidities (lung disease, kidney disease, prior cardiac surgery) that raise surgical risk.

Each must be assessed by a Heart Team, a multidisciplinary group of cardiologists and cardiac surgeons, and deemed suitable.

Candidacy is determined after thorough imaging, including CT angiography of the aortic root and access vessels, echocardiography (TTE/TOE), and coronary angiography.

Contraindications may include: - Anatomically unsuitable aortic root dimensions - Severe aortic regurgitation as the dominant lesion - Active endocarditis - Life expectancy below 1 year from non-cardiac cause

Korean cardiac centres use the same international scoring tools (STS score, EuroSCORE II) to assess risk. All major Korean TAVI programmes operate a formal Heart Team model as required by clinical guidelines.

If TAVI is not suitable, the Heart Team may recommend surgical valve replacement or, in selected very frail patients, balloon aortic valvuloplasty as a bridge.

How the Procedure Works

Before the procedure:

Patients undergo a comprehensive pre-procedure workup over 2–3 days.

• Multidetector CT (MDCT) scan of the chest, abdomen, and pelvis to measure aortic annulus dimensions and map access routes
• Transthoracic and/or transoesophageal echocardiography
• Coronary angiography to assess for coexisting coronary artery disease
• Blood tests, renal function, and coagulation studies
• Anaesthesia assessment

The procedure itself:

The most common access route is transfemoral — through the femoral artery in the groin — because it is the least invasive.

Alternative access (transapical, trans-subclavian, trans-aortic) is used when the femoral vessels are too small or calcified.

• The patient receives general anaesthesia or conscious sedation
• A sheath is inserted into the access vessel
• The delivery catheter, loaded with the compressed replacement valve (typically self-expanding or balloon-expandable), is advanced under fluoroscopic and echocardiographic guidance
• The valve is positioned across the native diseased valve and deployed
• Position and function are confirmed by imaging immediately
• The catheter and sheath are removed; the access site is closed

Korea's MFDS approved the second-generation VitaFlow Liberty® system (MicroPort CardioFlow) in December 2024, among other approved platforms. Both self-expanding and balloon-expandable valve technologies are available at major Korean centres.

Immediately after:

Patients are transferred to a cardiac intensive care unit (CICU) or high-dependency unit for monitoring overnight, then moved to a step-down ward.

Recovery Timeline

Days 1–3 (hospital):

Most patients are mobile within 24 hours of a transfemoral TAVI. Physiotherapy begins on day 1 or 2. Telemetry monitoring continues. A pacemaker is implanted during this period if heart block develops — this occurs in a minority of patients.

Days 4–8 (hospital to discharge):

Echocardiography is performed before discharge to confirm valve function. Antiplatelet therapy (typically dual antiplatelet for a period, then single agent) is initiated. Patients are counselled on activity restrictions and warning signs.

Weeks 1–2 (Korea recovery period):

International patients are advised to remain in Seoul for 7–10 days after discharge for an outpatient follow-up appointment and to confirm stability before a long-haul flight.

Light walking is encouraged. Heavy lifting, strenuous activity, and driving are restricted.

Weeks 2–6 (return home):

• Gradually return to daily activities
• Most patients report meaningful improvement in breathlessness and exercise tolerance within 2–4 weeks
• Outpatient cardiology follow-up at 1 month (can be arranged with a home cardiologist via telemedicine liaison)

3–12 months:

Echocardiographic follow-up at 3 months and 1 year to assess valve haemodynamics. Long-term anticoagulation planning is individualised — patients with atrial fibrillation may require oral anticoagulation.

TAVI valves are designed for long-term durability; durability data at 5–10 years continues to accumulate in global registries.

Cost

Costs vary by hospital and case. Ask the hospital for a written, itemised estimate before you decide.

Why Korea

Korea has established itself as Asia's leading TAVI destination through a combination of specialist volume, regulatory rigour, and accessible infrastructure.

Clinical volume and expertise:

TAVI is actively performed at approximately 20 institutions across Korea. Volume matters in structural heart intervention — higher-volume centres are associated with better procedural outcomes in global data. Korea's national TAVI Registry has tracked outcomes since the programme began in 2011, creating a strong quality-improvement feedback loop.

Regulatory standards:

All TAVI devices used in Korea must receive MFDS approval — the Korean equivalent of FDA or CE Mark clearance. Korea approved its first TAVI devices in line with international timelines and continued updating its approved device list, including second-generation systems in 2024.

MFDS standards are aligned with international GMP and clinical evidence requirements.

KHIDI and the Medical Korea brand:

KHIDI (Korea Health Industry Development Institute) manages the Medical Korea government programme, which promotes, coordinates, and quality-assures medical tourism nationally. Hospitals listed under Medical Korea meet defined service and safety standards for international patients. KHIDI also facilitates data sharing on exported medical technologies.

Seoul and Gangnam district:

Seoul concentrates the majority of Korea's tertiary cardiac centres. The Gangnam district specifically hosts several major hospital campuses with dedicated international patient departments, translators, and care coordination services — reducing the logistical burden for international patients travelling from abroad.

Cost advantage without quality compromise:

This reflects structural differences in hospital economics, not differences in device quality or clinical standards.

Short waiting times:

Unlike many public health systems in Europe or Canada, Korean private hospitals can schedule international TAVI patients within days to a few weeks of confirmed candidacy, subject to pre-procedure imaging results being available.

Related Topics

Sources

• Costs Associated with TAVI and SAVR in Korea — PMC / Journal of Chest Surgery
• Trends and Outcomes of TAVI in Korea: Korean TAVI Registry — PMC
• Aortic Stenosis and TAVI: Current Status and Future Directions in Korea — PMC
• Medical Korea — Heart Procedures (medicalkorea.or.kr)
• Medical tourism in South Korea — Wikipedia

International Patient Preparation Guides

Independent resources for international patients researching care in South Korea:

• Bringing Your Prescription Medications Into Korea: What to Know at Customs
• Sending Your Medical Records to Korea: A Data Privacy Guide

Hospitals offering TAVI Procedure