Transcatheter aortic valve replacement had a significantly higher total cost than surgical replacement (INT$ 40,776.9 vs. INT$ 12,393.7, p<0.001), primarily driven by the prosthetic valve cost.
Cohort (n=180)
No
Does isolated transcatheter aortic valve replacement (TAVR) reduce costs or improve outcomes compared to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis?
In the Brazilian public health system, TAVR is significantly more expensive than SAVR primarily due to device costs, but it offers shorter hospital stays and comparable 1-year mortality for high-risk patients.
Tasa de eventos absoluta: 40776.9% vs 12393.7%
valor p: p=<0.001
This study aimed to determine the financial implications of isolated transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in the Brazilian Public Health System (SUS) using time-driven activity-based costing (TDABC). We performed a retrospective observational cohort study at a single center from 2019 to 2022, including 180 patients (TAVR: n=65; SAVR: n=115). TAVR patients were older and had higher surgical risk. The total cost of TAVR was significantly higher than SAVR (INT 40, 776. 9 vs. INT 12, 393. 7, p <0. 001), primarily driven by the prosthetic valve cost. However, TAVR was associated with a shorter post-procedural length of stay (5 days vs. 7 days, p <0. 001) and lower absolute 1-year mortality rates (3. 1% vs. 6. 1%), although this difference did not reach statistical significance (p=0. 60). Most TAVR cases were accessed through litigation due to the lack of formal incorporation in the public system during the study period, which contributed to higher baseline frailty. In conclusion, while TAVR remains more expensive due to device costs, it offers clinical advantages in high-risk populations within a developing healthcare system.
Saadi et al. (Wed,) conducted a cohort in Severe Aortic Stenosis (n=180). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Total cost (INT$) (p=<0.001). Transcatheter aortic valve replacement had a significantly higher total cost than surgical replacement (INT$ 40,776.9 vs. INT$ 12,393.7, p<0.001), primarily driven by the prosthetic valve cost.