TAIPEI (Taiwan News) — National Taiwan University Hospital announced Wednesday a simplified transcatheter aortic valve replacement procedure that reduces the need for general anesthesia and intensive care, allowing some patients to be discharged as early as the day after surgery.
NTUH said the simplified TAVR approach uses only local anesthesia with conscious sedation and eliminates routine valve pre-dilation. It avoids the use of temporary pacing wires, though strict patient selection is required.
As Taiwan enters a super-aged society, hospital officials said the incidence of valvular heart disease is expected to rise steadily, per CNA.
NTUH’s Cardiovascular Center introduced the simplified TAVR procedure at the end of 2024. After one year of implementation, 30 patients (33%) were transferred directly to general wards after surgery, and 17 patients (19%) were discharged the following day.
NTUH Superintendent Yu Chong-jen (余忠仁) said advances in childhood vaccination and antibiotic use have reduced valvular disease caused by infection, shifting the patient population from children to older adults, mainly due to degenerative valve conditions. He added that simplified TAVR techniques offer faster recovery compared with traditional open-chest aortic valve replacement surgery.
NTUH cardiologist Lin Mao-hsin (林茂欣) said the world’s first successful TAVR was performed by a French surgeon in 2002. NTUH conducted its first TAVR procedure in 2010.
Traditional TAVR typically involves preoperative hospitalization for evaluation, general anesthesia, and routine admission to intensive care units after surgery, with hospital stays of five to 10 days or longer, Lin said. Most hospitals in Asia still rely on conventional TAVR procedures, while many countries in Europe and the US have adopted simplified approaches for years.
According to Lin, simplified TAVR prioritizes patient safety and comfort by reducing anxiety and fear, encouraging early ambulation. The approach also lowers the risk of hospital-acquired infections among elderly patients and helps avoid complications associated with prolonged bed rest.
Lin said the simplified TAVR procedure remains costly and is only conditionally covered by Taiwan’s National Health Insurance, with all cases subject to review. Coverage is generally limited to high-risk patients, including the very elderly or those with multiple comorbidities.
Health Minister Shih Chung-liang (石崇良) said simplified TAVR is a relatively low-risk option but involves cost and technical barriers. He said the National Health Insurance Administration is discussing whether to expand coverage for the procedure.
On the possibility of broader coverage, Shih said any decision would follow established NHI procedures, including health technology assessments and reference to international recommendations, while also taking cost-effectiveness and financial considerations into account.
