Effect of Availability of Transcatheter Aortic-Valve Replacement on Clinical Practice

• Published in: The New England journal of medicine Vol. 373; no. 25; pp. 2438 - 2447
• Main Authors: Reinöhl, Jochen, Kaier, Klaus, Reinecke, Holger, Schmoor, Claudia, Frankenstein, Lutz, Vach, Werner, Cribier, Alain, Beyersdorf, Friedhelm, Bode, Christoph, Zehender, Manfred
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 17.12.2015
• Subjects: Age Factors; Aged; Aged, 80 and over; Aortic Valve - surgery; Aortic Valve Stenosis - surgery; Catheters; Coronary vessels; Data processing; Female; Germany; Heart; Heart surgery; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Heart Valve Prosthesis Implantation - trends; Hospital Mortality; Humans; Male; Middle Aged; Mortality; Transcatheter Aortic Valve Replacement - mortality; Transcatheter Aortic Valve Replacement - trends; Transcatheter Aortic Valve Replacement - utilization; Transplants & implants; Germany
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1500893

In Germany, the use of TAVR increased substantially between 2007 and 2013, whereas the use of surgical aortic-valve replacement decreased modestly. Patients undergoing TAVR were older and at higher operative risk. Mortality decreased over time in both groups. Surgical aortic-valve replacement was a major clinical advance in the 1960s 1 and offered a cure for aortic stenosis, a condition for which no disease-modifying pharmacologic therapy is available. Surgical replacement remained the only treatment option until 2007, when devices for transcatheter aortic-valve replacement (TAVR) were approved. 2 Since then, TAVR has become established not only as an effective therapy for patients for whom surgery is not an option 3 but also as an alternative for high-risk patients. 4 The introduction of TAVR has led to questions about the effect of this relatively new approach on current clinical practice and its effect on surgical . . .