Transcatheter aortic valve replacement is cost effective compared with surgical replacement for low-risk patients

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Data from PARTNER 3, a randomized trial comparing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis and low risk of surgery Economic analysis shows that despite the high procedural costs, using TAVR over two years resulted in longer expected life after follow-up and quality adjustments and lower total costs. As a result, two years later, TAVR was cost-effective for these patients.

Findings reported today at TCT 2021, 33rd The Cardiovascular Institute (CRF) Annual Science Symposium.

Previous studies have shown that TAVR is more cost effective than Medical therapy For the patient Severe aortic stenosis Comparison of extreme surgical risk with SAVR in patients with moderate and high surgical risk.Based on recent results trial, PARTNER 3 and TAVR are approved for low-risk patients in the United States. Currently, there is little evidence of whether TAVR is cost-effective for low-risk patients.

Between March 2016 and October 2017, 979 patients in the United States were enrolled in the PARTNER 3 trial and randomized to TAVR using the SAPIEN 3 valve (n = 492) or SAVR (n = 487). it was done. Of these, 485 received TAVR and 444 received SAVR. During index hospitalization, TAVR was ICU (0.7 days vs. 2.6 days) and non-ICU length of stay (1.2 days vs. 3.7 days, all p

Costs were assessed based on a combination of resource utilization (for the first TAVR and SAVR procedures) and all other linked Medicare claims. cost Up to 2 years. In the study population, index admission costs were $ 47,196 for TAVR and $ 46,606 for SAVR (a difference of $ 591). Follow-up costs for the two years after discharge were lower for TAVR compared to SAVR ($ 19,638 vs. $ 22,258, $ 2,620 difference). Overall, the total cost for the two years was lower for TAVR and SAVR ($ 66,834 vs. $ 68,864, $ 2,030 difference). 2 years quality-adjusted life year Average life TAVRs were greater than SAVRs (1.71 vs. 1.66 quality-adjusted life years, p = 0.06) — driven by early benefits in both quality of life and survival. Long-term results are unknown at this time, but assuming there is no long-term difference in survival or cost, TAVR is the economically dominant strategy (low cost, better results) with a 95% chance. Was predicted to be cost effective. With SAVR.

“Data from the PARTNER3 trial show that for patients with severe aortic stenosis and low surgical risk, TAVR can save money compared to SAVR with a two-year follow-up and is cost-effective for life. It is predicted. There is no significant difference in late-onset mortality between the two strategies. ” “Given the importance of long-term results in these forecasts, a long-term follow-up of at least 10 years is important to validate these findings.”

Medium-risk patients show similar 5-year outcomes with transcatheter or surgical aortic valve replacement

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Quote: Transcatheter aortic valve replacement was obtained from on November 8, 2021 in low-risk patients (November 2021). 8 days) It is more cost effective compared to surgical replacement. Surgical.html

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