Utilization and outcomes of transcatheter aortic valve replacement in the United States shortly after device approval

2017 ◽  
Vol 90 (5) ◽  
pp. 830-838 ◽  
Author(s):  
Michael N. Young ◽  
Sammy Elmariah ◽  
Kevin F. Kennedy ◽  
Ignacio Inglessis ◽  
Robert W. Yeh
Keyword(s):  
United States ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
The United States ◽  
Transcatheter Aortic Valve ◽  
Device Approval

Temporal Trends in Resource Use, Cost, and Outcomes of Transcatheter Aortic Valve Replacement in the United States

2020 ◽  
Vol 95 (12) ◽  
pp. 2665-2673
Author(s):  
Akram Kawsara ◽  
Samian Sulaiman ◽  
Jane Linderbaum ◽  
Sarah R. Coffey ◽  
Fahad Alqahtani ◽  
...  
Keyword(s):  
United States ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Resource Use ◽  
Transcatheter Aortic Valve Replacement ◽  
Temporal Trends ◽  
The United States ◽  
Transcatheter Aortic Valve

scholarly journals Socioeconomic and Geographic Characteristics of Hospitals Establishing Transcatheter Aortic Valve Replacement Programs, 2012–2018

2021 ◽  
Author(s):  
Ashwin S. Nathan ◽  
Lin Yang ◽  
Nancy Yang ◽  
Sameed Ahmed M. Khatana ◽  
Elias J. Dayoub ◽  
...  
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Metropolitan Areas ◽  
The United States ◽  
Medicare Beneficiaries ◽  
Transcatheter Aortic Valve

Background: Despite the benefits of novel therapeutics, inequitable diffusion of new technologies may generate disparities. We examined the growth of transcatheter aortic valve replacement (TAVR) in the United States to understand the characteristics of hospitals that developed TAVR programs and the socioeconomic status of patients these hospitals served. Methods: We identified fee-for-service Medicare beneficiaries aged 66 years or older who underwent TAVR between January 1, 2012, and December 31, 2018, and hospitals that developed TAVR programs (defined as performing ≥10 TAVRs over the study period). We used linear regression models to compare socioeconomic characteristics of patients treated at hospitals that did and did not establish TAVR programs and described the association between core-based statistical area level markers of socioeconomic status and TAVR rates. Results: Between 2012 and 2018, 583 hospitals developed new TAVR programs, including 572 (98.1%) in metropolitan areas, and 293 (50.3%) in metropolitan areas with preexisting TAVR programs. Compared with hospitals that did not start TAVR programs, hospitals that did start TAVR programs treated fewer patients with dual eligibility for Medicaid (difference of −2.83% [95% CI, −3.78% to −1.89%], P ≤0.01), higher median household incomes (difference $2447 [95% CI, $1348–$3547], P =0.03), and from areas with lower distressed communities index scores (difference −4.02 units [95% CI, −5.43 to −2.61], P ≤0.01). After adjusting for the age, clinical comorbidities, race and ethnicity and socioeconomic status, areas with TAVR programs had higher rates of TAVR and TAVR rates per 100 000 Medicare beneficiaries were higher in core-based statistical areas with fewer dual eligible patients, higher median income, and lower distressed communities index scores. Conclusions: During the initial growth phase of TAVR programs in the United States, hospitals serving wealthier patients were more likely to start programs. This pattern of growth has led to inequities in the dispersion of TAVR, with lower rates in poorer communities.

Economic Considerations in Access to Transcatheter Aortic Valve Replacement

2022 ◽  
Author(s):  
Kriyana P. Reddy ◽  
Peter W. Groeneveld ◽  
Jay Giri ◽  
Alexander C. Fanaroff ◽  
Ashwin S. Nathan
Keyword(s):  
United States ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
The United States ◽  
Socioeconomically Disadvantaged ◽  
Transcatheter Aortic Valve ◽  
Economic Considerations

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, with the number of procedures and sites offering the procedure steadily rising over the past decade in the United States. Despite this, growth into certain markets has been limited as hospitals have to balance high TAVR costs with the ability to offer a complete array of state-of-the-art therapies for aortic stenosis. This trade-off often results in decreased access to TAVR services by patients cared for in hospitals that cannot afford these services or have difficulty meeting procedural requirements, recruiting skilled physicians, and initiating and then maintaining a functioning TAVR program. The lack of access is more common among patients of color or those who are socioeconomically disadvantaged. The purpose of this review is to describe the hospital-level economic considerations of TAVR in the United States and the resulting effects on geographic, racial, ethnic, and socioeconomic access for Americans.

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States

2015 ◽  
Vol 100 (5) ◽  
pp. 1718-1727 ◽  
Author(s):  
Vinod H. Thourani ◽  
Hanna A. Jensen ◽  
Vasilis Babaliaros ◽  
Rakesh Suri ◽  
Sreekanth Vemulapalli ◽  
...  
Keyword(s):  
United States ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
The United States ◽  
Transcatheter Aortic Valve
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