Great progress has been made in treating aortic stenosis, a heart problem that reportedly affects at least 1.5 million Americans.

In severe cases of aortic stenosis, calcium buildup has narrowed the opening of the aortic valve to the point where, if left untreated, can lead to heart failure and death.

There apparently have been no statistics presented publicly about the prevalence of the condition to people in the six-county Southern Alleghenies region, or even statewide, but no doubt the condition has a local presence.

It might be puzzling to some people why this topic has reached the Mirror’s opinion page at this time, but it is a legitimate candidate for such discussion, considering a finding related to the breakthrough procedure for treating the condition.

The finding should be the basis for patients with the condition having a frank, in-detail, all-aspects-and-risks discussion regarding the procedure in question — about whether to opt for the simpler breakthrough or choose surgical aortic valve replacement, which is more invasive and has a longer recovery time.

It also isn’t unreasonable to question whether some insurers might someday — if they haven’t already done so, in some instances — discourage the more invasive option simply because of its presumably higher cost, even if that were the physician-recommended option based on the patient’s age and other physical and health circumstances.

The breakthrough heart procedure in question is transcatheter aortic valve replacement, or TAVR, which the Wall Street Journal, in a lengthy article in its April 25-26 edition, pointed out comes with what the newspaper called “risky tradeoffs.”

Two paragraphs in the Journal’s article can be judged of particular importance to individuals possibly facing a decision regarding TAVR. They are as follows:

“TAVR was approved in 2011 for frail, older patients unlikely to withstand surgery — people with no more than a few years left to live. The Food and Drug Administration later approved it for healthier patients at intermediate and low risk of dying from surgery.

“Yet there’s limited research on how long the valves might last. And as TAVR has become more widely used among younger and healthier people, some are finding that their valves don’t work as well or last as long as they hoped. The procedure they thought would spare them a complicated surgery leads some to the operating table anyway.”

The article notes later that some patients experiencing TAVR failure end up requiring an “explant,” which the Journal described as a complex surgery, not without risk, to remove the original aortic valve along with the TAVR valve and sew in a new surgical one.

The TAVR procedure involves doctors making a small puncture in an artery, usually in the groin, and feeding a catheter up into the patient’s heart. Next, a replacement valve, encased in a metal frame, is guided to the aortic valve. Finally, the procedure, which typically takes one or two hours, involves expanding the metal frame, pushing aside the old valve and sealing the replacement valve in place.

Patients usually go home in one or two days, not having experienced the physical and emotional trauma of open-heart surgery, which can involve months of recovery time.

Dr. Vinay Badhwar, president of the Society of Thoracic Surgeons and executive chair of the West Virginia University Heart & Vascular Institute, was quoted in the Journal as saying “our focus must be on the optimal long-term outcome.”

For the lives of many, that focus also must involve plenty of right decisions guided by caution and reality, not by haste alone.