August 27, 2026Journal of the American College of CardiologyOpen Access

Hospital Resource Utilization Before and After Transcatheter Aortic Valve Replacement

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe aortic stenosis (n=15324). Intervention: Transcatheter aortic valve replacement (TAVR) vs. Pre-TAVR period. Primary outcome: Heart failure hospitalization rates (RR 0.87, p=<0.01).

Q: What question did this study set out to answer?

To evaluate the impact of transcatheter aortic valve replacement (TAVR) on all-cause, cardiovascular, and noncardiovascular hospitalizations, hospital days, and inpatient costs in patients with severe aortic stenosis.

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Why the study?

Patients with severe aortic stenosis experience repeat hospitalizations for multiple conditions, prompting evaluation of the effect of TAVR on hospitalizations.

Does TAVR alter hospital resource utilization (hospitalizations and costs) in patients with severe aortic stenosis compared to the pre-TAVR period?

Population

15,324 patients at 328 sites undergoing TAVR with Medicare linkage

Comparison

Post-TAVR vs pre-TAVR (year pre-TAVR and post-TAVR)

Design

Registry-based cohort study linked to Medicare claims

Follow-up

1 year post-TAVR

Key result

Transcatheter aortic valve replacement was associated with reduced heart failure hospitalizations (RR 0.87, p<0.01) but increased all-cause and noncardiovascular hospitalizations compared to pre-TAVR.

Authors

SVSreekanth Vemulapalli DDDavid Dai BHBradley G. Hammill

Discussion

Member takes

Overview

TAVR may lower HF hospitalizations and costs in severe AS; leaves open net resource impact across broader real-world populations.

Key Points

To evaluate the impact of transcatheter aortic valve replacement (TAVR) on all-cause, cardiovascular, and noncardiovascular hospitalizations, hospital days, and inpatient costs in patients with severe aortic stenosis.
Linked Society of Thoracic Surgeons/American College of Cardiology TVT registry records to Medicare claims for N=15,324 patients undergoing TAVR across 328 sites.
Utilized multivariable modeling to evaluate rate ratios of hospitalizations, hospital days, and inpatient costs comparing the 1 year pre-TAVR to the 1 year post-TAVR period.
Post-TAVR heart failure hospitalization rates (rate ratio [RR]: 0.87, p < 0.01) and hospital days (RR: 0.95, p < 0.01) decreased, with the largest reduction observed in patients with left ventricular ejection fraction <30%.
All-cause, noncardiovascular, and bleeding hospitalization rates and hospitalized days significantly increased post-TAVR compared to pre-TAVR (p < 0.01 for all).
Mean inpatient costs decreased post-TAVR among the overall cohort (RR: 0.95, p < 0.01) and among 1-year survivors (RR: 0.90, p < 0.01).

Study Design

Type

Cohort (n=15,324)

Multicenter

Yes

Structured PICO

Does TAVR alter hospital resource utilization (hospitalizations and costs) in patients with severe aortic stenosis compared to the pre-TAVR period?

Population

15,324 Medicare-linked patients (median age 84) with severe aortic stenosis undergoing TAVR across 328 sites, evaluated for 1-year pre- and post-procedure hospitalizations and costs.

Exposure

Transcatheter aortic valve replacement (TAVR)

Comparator

Pre-TAVR period (1 year prior to procedure)

Outcome

Rates of all-cause, cardiovascular, and noncardiovascular hospitalizations, hospital days, and inpatient costs in the year pre-TAVR and post-TAVRhard clinical

Main Result

Relative Risk: 0.87

p-value: p=<0.01

TAVR reduces heart failure hospitalizations and overall inpatient costs but is associated with increased all-cause, noncardiovascular, and bleeding hospitalizations in the year following the procedure.

Cite This Study

Vemulapalli et al. (2019) conducted a cohort in Severe aortic stenosis (n=15,324). Transcatheter aortic valve replacement (TAVR) vs. Pre-TAVR period was evaluated on Heart failure hospitalization rates (RR 0.87, p=<0.01). Transcatheter aortic valve replacement was associated with reduced heart failure hospitalizations (RR 0.87, p<0.01) but increased all-cause and noncardiovascular hospitalizations compared to pre-TAVR.

synapsesocial.com/papers/6a9000fc2e4bea8bbd45c694 https://doi.org/10.1016/j.jacc.2018.12.049

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August 27, 2026Journal of the American College of CardiologyOpen Access

Hospital Resource Utilization Before and After Transcatheter Aortic Valve Replacement

View Full Paper

Ask AI

Bookmark

Why the study?

Patients with severe aortic stenosis experience repeat hospitalizations for multiple conditions, prompting evaluation of the effect of TAVR on hospitalizations.

Does TAVR alter hospital resource utilization (hospitalizations and costs) in patients with severe aortic stenosis compared to the pre-TAVR period?

Population

15,324 patients at 328 sites undergoing TAVR with Medicare linkage

Comparison

Post-TAVR vs pre-TAVR (year pre-TAVR and post-TAVR)

Design

Registry-based cohort study linked to Medicare claims

Follow-up

1 year post-TAVR

Key result

Authors

SVSreekanth Vemulapalli DDDavid Dai BHBradley G. Hammill

Discussion

Member takes

Overview

TAVR may lower HF hospitalizations and costs in severe AS; leaves open net resource impact across broader real-world populations.

Key Points

To evaluate the impact of transcatheter aortic valve replacement (TAVR) on all-cause, cardiovascular, and noncardiovascular hospitalizations, hospital days, and inpatient costs in patients with severe aortic stenosis.
Linked Society of Thoracic Surgeons/American College of Cardiology TVT registry records to Medicare claims for N=15,324 patients undergoing TAVR across 328 sites.
Utilized multivariable modeling to evaluate rate ratios of hospitalizations, hospital days, and inpatient costs comparing the 1 year pre-TAVR to the 1 year post-TAVR period.
Post-TAVR heart failure hospitalization rates (rate ratio [RR]: 0.87, p < 0.01) and hospital days (RR: 0.95, p < 0.01) decreased, with the largest reduction observed in patients with left ventricular ejection fraction <30%.
All-cause, noncardiovascular, and bleeding hospitalization rates and hospitalized days significantly increased post-TAVR compared to pre-TAVR (p < 0.01 for all).
Mean inpatient costs decreased post-TAVR among the overall cohort (RR: 0.95, p < 0.01) and among 1-year survivors (RR: 0.90, p < 0.01).

Study Design

Type

Cohort (n=15,324)

Multicenter

Yes

Structured PICO

Does TAVR alter hospital resource utilization (hospitalizations and costs) in patients with severe aortic stenosis compared to the pre-TAVR period?

Population

15,324 Medicare-linked patients (median age 84) with severe aortic stenosis undergoing TAVR across 328 sites, evaluated for 1-year pre- and post-procedure hospitalizations and costs.

Exposure

Transcatheter aortic valve replacement (TAVR)

Comparator

Pre-TAVR period (1 year prior to procedure)

Outcome

Rates of all-cause, cardiovascular, and noncardiovascular hospitalizations, hospital days, and inpatient costs in the year pre-TAVR and post-TAVRhard clinical

Main Result

Relative Risk: 0.87

p-value: p=<0.01

Cite This Study

synapsesocial.com/papers/6a9000fc2e4bea8bbd45c694 https://doi.org/10.1016/j.jacc.2018.12.049

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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