title: The economic value of rapid deployment aortic valve replacement via full sternotomy.
abstract: OBJECTIVE
  To compare the economic value of EDWARDS INTUITY Elite™ (EIE) valve system for rapid-deployment aortic valve replacement (RDAVR) in a full sternotomy (FS) approach (EIE-FS-RDAVR) versus FS-AVR using conventional stented bioprosthesis.
  
  
  METHODS
  A simulation model to compare each treatment's 30-day inpatient utilization and complication rates utilized: clinical end points obtained from the TRANSFORM trial patient subset (EIE-FS-RDAVR) and a best evidence review of the published literature (FS-AVR); and costs from the Premier database and published literature.
  
  
  RESULTS
  EIE-FS-RDAVR costs $800 less than FS-AVR per surgery episode attributable to lowered complication rates and utilization. Combined with the lower mortality, EIE-FS-RDAVR was a superior (dominant) technology versus FS-AVR.
  
  
  CONCLUSIONS
  This preliminary investigation of EIE-FS-RDAVR versus conventional FS-AVR found the EIE valve offered superior economic value over a 30-day period. Real-world analyses with additional long-term follow-up are needed to evaluate if this result can be replicated over a longer timeframe.
authors.affiliation: Edwards Lifesciences, Inc., Irvine, CA, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Moore
authors.affiliation: Swedish Heart & Vascular Institute, Seattle, WA, USA.
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Barnhart
authors.affiliation: East Carolina University, Greenville, NC, USA.
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
authors.affiliation: Stony Brook University, Stony Brook, NY, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Rizzo
authors.affiliation: CTI Clinical Trial & Consulting Services, Inc., Cincinnati, OH, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Gunnarsson
authors.affiliation: CTI Clinical Trial & Consulting Services, Inc., Cincinnati, OH, USA.
authors.forename: Swetha R
authors.initials: SR
authors.lastname: Palli
authors.affiliation: New York University School of Medicine, New York, NY, USA.
authors.forename: Eugene A
authors.initials: EA
authors.lastname: Grossi
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000191:economics / Q000601:surgery; D001705:Bioprosthesis / Q000191:economics / Q000706:statistics & numerical data*; D057186:Comparative Effectiveness Research / Q000379:methods / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006350:Heart Valve Prosthesis / Q000191:economics / Q000706:statistics & numerical data*; D019918:Heart Valve Prosthesis Implantation / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015607:Stents / Q000191:economics / Q000706:statistics & numerical data*; D056346:Sternotomy / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome
keywords: INTUITY; TRANSFORM trial; aortic valve replacement; cost evaluation; full sternotomy; rapid deployment; simulation; symptomatic aortic stenosis