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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe Cost Effectiveness of Transcatheter Aortic Valve Replacement Compared with Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis: Results from The PARTNER Trial (Cohort A) study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00530894\u0026amp;atom=%2Fspmdc%2F11%2F14%2F5.1.atom\u0022\u003ENCT00530894\u003C\/a\u003E; Leon MB et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2010] compared transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement in patients with high operative risk from cohort A of the PARTNER trial. The study combined cost data with survival and quality of life data to estimate the 12-month cost-effectiveness of TAVI.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EValvular Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe Cost Effectiveness of Transcatheter Aortic Valve Replacement Compared with Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis: Results from The PARTNER Trial (Cohort A) study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00530894\u0026amp;atom=%2Fspmdc%2F11%2F14%2F5.1.atom\u0022\u003ENCT00530894\u003C\/a\u003E; Leon MB et al. \u003Cem\u003ENEJM\u003C\/em\u003E 2010], presented by Matthew R. Reynolds, MD, MSC, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA, compared transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in patients with high operative risk from cohort A of the PARTNER trial. The study combined cost data with survival and quality of life (QoL) data to estimate the 12-month cost-effectiveness of TAVI.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThis study was a 12-month analysis that was based on observed survival, QoL, health care resource use, and hospital billing data. The primary effectiveness measure was quality-adjusted life-years (QALYs)\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThree populations were analyzed. The primary population (n=647) for the full cost-effectiveness analysis consisted of patients in whom TAVI or SAVR was attempted, with complete follow-up until death or 1 year. The secondary population (n=657) comprised patients in whom TAVI or SAVR was attempted, including patients who withdrew or were lost to follow-up. The per-protocol population (n=647) consisted of those who were analyzed for procedural resource utilization and costs only and excluded patients in whom TAVI or SAVR was abandoned. Due to the significant interaction between treatment effect and access site, TAVI patients were stratified into transfemoral or transapical approach.\u003C\/p\u003E\u003Cdiv class=\u0022section results\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETransfemoral Results\u003C\/h2\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EAt 12 months, the average QALYs was significantly higher among the 239 patients who underwent transfemoral TAVI compared with the 217 patients who had SAVR (0.659 vs 0.591 QALYs, respectively; difference 0.068, 95% CI, 0.017 to 0.123). Resource use in the per-protocol population was significantly lower for transfemoral TAVI versus SAVR with respect to procedure duration (244\u00b178 vs 330\u00b1102 minutes; p\u0026lt;0.001) and total hospital days (10.2 vs 16.4; p\u0026lt;0.001). Major vascular complications were significantly more frequent in transfemoral TAVI patients versus SAVR patients (13.2% vs 3.2%, respectively; p\u0026lt;0.001). Major bleeding was lower in transfemoral TAVI patients versus SAVR patients (9.4% vs 22.6%, respectively; p\u0026lt;0.001). As noted in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E, compared with SAVR, patients who were undergoing transfemoral TAVI had higher procedural costs but slightly lower overall index admission total costs. Total 12-month follow-up costs were not significantly different for transfemoral TAVI versus SAVR ($22,251 vs $21,965, respectively; p=0.97).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12638\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12638\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12638\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EIndex Admission Fees.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section results\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETransapical Results\u003C\/h2\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EAt 12 months, QALYs were lower in the patients who underwent transapical TAVI compared with SAVR (0.570 vs 0.64 QALYs, respectively; difference \u22120.070, 95% CI, \u22120.151 to 0.012). Procedural, index admission, and total 12-month costs were increased with transapical TAVI versus SAVR by roughly $11,000.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EDr. Reynolds concluded that for patients with severe aortic stenosis and high surgical risk, TAVI is an economically attractive and possibly dominant strategy compared with SAVR, provided that patients are suitable for the transfemoral approach. Current results for transapical TAVI compared with SAVR are not attractive from a health economic perspective.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/14\/5.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmvy1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmvy1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}