TAVR resulted in a shorter average length of stay and lower procedural costs compared to SAVR across various comorbidities, although it was associated with a higher rate of permanent pacemaker implantation.
Systematic Review
Does Transcatheter Aortic Valve Replacement (TAVR) improve length of stay, cost, and complications compared to Surgical Aortic Valve Replacement (SAVR) in patients requiring aortic valve replacement?
TAVR offers a cost-effective alternative to SAVR with shorter hospital stays and fewer bleeding complications, though it carries a higher risk of permanent pacemaker implantation across various patient comorbidities.
This review provides an in-depth analysis of the effect of length of stay (LOS), comorbidities, and procedural complications on the cost-effectiveness of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR). We found that the average LOS was shorter for patients undergoing TAVR, contributing to lower average costs associated with the procedure, although the LOS varied between patients due to the severity of illness and comorbidities present. TAVR has also been found to improve the quality of life for patients receiving aortic valve replacement compared to SAVR. Although TAVR has a lower rate of most post-operative complications caused by SAVR, such as bleeding and cardiac complications, TAVR shows an increased rate of permanent pacemaker (PPM) implantation due to mechanical trauma on the heart's conduction system. In addition, our findings suggest that the cost-effectiveness of each procedure varies based on the types of valve, the patient history of other medical conditions, and the procedural methods. Our findings show that TAVR is preferred over SAVR in terms of cost-effectiveness across a variety of patients with other coexisting medical conditions, including cancer, advanced kidney disease, cirrhosis, diabetes mellitus, and bundle branch block. TAVR also appears to be superior to SAVR with fewer post-operative complications. However, TAVR appears to have a higher rate of PPM implantation rates as compared to SAVR. The comorbidities of the valve recipient must be considered when deciding whether to use TAVR or SAVR as cost-effectiveness varies with the patient background.
Kermanshahchi et al. (Mon,) conducted a systematic review in Aortic stenosis. Transcatheter Aortic Valve Replacement (TAVR) vs. Surgical Aortic Valve Replacement (SAVR) was evaluated on Length of stay and cost-effectiveness. TAVR resulted in a shorter average length of stay and lower procedural costs compared to SAVR across various comorbidities, although it was associated with a higher rate of permanent pacemaker implantation.
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