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  • Progressing Toward Lower High Resource Utilization in TAVR

    Transcatheter aortic valve replacement (TAVR) has become the preferred approach for severe aortic stenosis in inoperable and high-surgical-risk patients, and is a non-inferior and less invasive management option for intermediate- and low-risk patients. With the expanded indication into the low-surgical-risk population, the number of patients undergoing TAVR is projected to increase substantially. In addition to clinical trials aimed at assessing the long-term performance of TAVR, the economic implications of TAVR trends are also an important consideration. Numerous cost-effectiveness analyses comparing TAVR with surgical aortic valve replacement (SAVR) have been performed. In the PARTNER A trial of high-risk patients, TAVR from the transfemoral access showed modest benefit in quality-adjusted life expectancy and reduced costs compared with SAVR. Economic analysis of PARTNER 2A trial showed an even greater quality-adjusted life expectancy and lower costs of TAVR compared to SAVR in intermediate-risk patients. One of the key reasons for favorable cost effectiveness of TAVR is marked improvements in post-procedural care over time leading to a reduction in high resource utilization.

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