There are no data for the use of TAVI in patients 2. Both SAVR and TAVI are effective approaches to AVR in adults 65 to 80 years of age. Patients enrolled in RCTs of TAVI versus SAVR had high- velocity severe AS (Stage D1). However, less robust data from observational studies and regis- try data are encouraging with regard to TAVI for symptomatic patients with low-flow, low-gradi- ent severe AS (Stages D2 and D3). Thus, these guidelines make the same recommendations for symptomatic patients with confirmed severe AS regardless of flow rate. TAVI has a slightly lower mortality risk and is associated with a shorter hos- pital length of stay, more rapid return to normal activities, lower risk of transient or permanent AF, less bleeding, and less pain than SAVR. On the other hand, SAVR is associated with a lower risk of paravalvular leak, less need for valve reinterven- tion, and less need for a permanent pacemaker. When the choice of SAVR or TAVI is being made in an individual patient between 65 and 80 years of age, other factors, such as vascular access, comorbid cardiac and noncardiac conditions that affect risk of either approach, expected functional status and survival after AVR, and patient values and preferences, must be considered. The choice of mechanical or bioprosthetic SAVR (Section 11) versus a TAVI is an important consideration and is influenced by durability considerations, because durability of transcatheter valves beyond 5 to 6 years is not yet known.2 3. TAVI is a safe and effective procedure for treat- ment of severe symptomatic AS in all adults regardless of estimated surgical risk. The mortality rate for transfemoral TAVI is lower than that for SAVR, with a HR of 0.88 and a 95% CI of 0.78 to 0.99 in a meta-analysis of RCTs. 