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Prog Cardiovasc Dis. 2014 May-Jun;56(6):610-8. doi: 10.1016/j.pcad.2014.03.001. Epub 2014 Mar 5.

Quality, economics, and national guidelines for transcatheter aortic valve replacement.

Author information

1
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN. Electronic address: pollak.peter@mayo.edu.
2
The Heart Hospital Baylor, Plano, TX.
3
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN.

Abstract

Transcatheter aortic valve replacement (TAVR) is a transformative technology for the treatment of aortic stenosis, requiring a multidisciplinary collaboration in the form of a "heart team" that includes interventional cardiologists and cardiac surgeons. As this new technology continues to disperse rapidly, its proper therapeutic role evolves and leads to important questions regarding who should perform the procedure, where it should be performed, and who should pay for it. Herein, we review the most recent guidelines governing the use of TAVR in the United States and Europe. We then summarize the available registry data, which, despite its limitations, presents the clearest picture of TAVR in clinical use. Finally, we discuss the costs and relative cost-effectiveness of TAVR. Taken together, these are the elements from which the larger questions surrounding TAVR must be answered.

KEYWORDS:

Aortic stenosis; Cost; Cost-effectiveness; National guidelines; Quality; Transcatheter aortic valve replacement

PMID:
24838136
DOI:
10.1016/j.pcad.2014.03.001
[Indexed for MEDLINE]

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