title: Resource utilization and procedure-related costs associated with transfemoral transcatheter aortic valve replacement.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) is an alternative to surgical valve replacement for patients with aortic stenosis (AS). This study assessed the impact of changing from a self-expandable (SE) valve to a balloon-expandable (BE) valve on healthcare resource use and procedural costs in a population of inoperable AS patients.
  
  
  METHODS
  In this retrospective single center study, data for 195 patients who received either an SE or a BE valve between 2010-2014 were collected. Procedural and post-procedural healthcare resource use and cost parameters were determined for the two groups.
  
  
  RESULTS
  The study showed that overall procedural time, including time required by medical personnel, was significantly shorter for TAVI using a BE compared with an SE valve. Post-surgery, patients in the BE valve group had significantly shorter hospital stays than the SE valve group, including significantly fewer days spent in the intensive care unit (ICU). Additionally, trends towards reduced 30-day mortality, incidence of new permanent pacemaker implantation, and incidence of blood transfusion were observed in the BE valve group compared with the SE valve group. Finally, total procedural costs were 24% higher in the SE compared with the BE valve group.
  
  
  CONCLUSIONS
  The BE valve data were acquired in a single year, whereas the SE valve data were from a 5-year period. However, a year-by-year analysis of patient characteristics and study outcomes for the SE valve group showed few significant differences over this 5-year period.
  
  
  CONCLUSIONS
  Overall, changing from an SE to a BE valve for TAVI in patients with severe AS reduced both healthcare resource use and procedure-related costs, while maintaining patient safety. For healthcare providers, this could increase efficiency and capacity within the healthcare system, with the added advantage of reducing costs.
authors.affiliation: a Universitäts-Herzzentrum Freiburg Bad Krozingen , Bad Krozingen , Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Klein
authors.affiliation: b Edwards Lifesciences SA , Nyon , Switzerland.
authors.forename: Jana
authors.initials: J
authors.lastname: Boleckova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D065467:Transcatheter Aortic Valve Replacement / Q000191:economics* / Q000379:methods*
keywords: Aortic stenosis; Balloon-expandable valve; Cost; Resource; TAVI