Posted on 12/02/2017 9:01:27 AM PST by Utah Binger
Analysis of the PARTNER 2A trial and the SAPIEN-3 Intermediate Risk registry found transcatheter aortic valve replacement (TAVR) to be highly cost-effective compared with surgical aortic valve replacement (SAVR) in intermediate surgical risk patients with aortic stenosis.
Findings were reported today at the 29th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.
Researchers led by Dr. David J. Cohen (Saint Luke's Mid America Heart Institute, Kansas City, MO) used data from the PARTNER 2A randomized trial and the SAPIEN-3 Intermediate Risk registry to perform a formal, patient-level economic analysis comparing TAVR using either the SAPIEN XT valve (XT-TAVR) or the SAPIEN-3 valve (S3-TAVR) with SAVR. The comparison between XT-TAVR and SAVR was based upon randomized assignment within PARTNER 2A; the comparison between S3-TAVR and SAVR was not randomized. Procedural costs were assessed based on measured resource utilization and all other costs were assessed by linking trial data with Medicare claims for the index hospitalization and follow-up period or by piecewise regression models for the remaining patients. "If we used purely volume-based criteria to judge hospitals good or bad, we would misclassify nearly 45 percent of all hospitals in the U.S.," said senior author Dr. Dharam Kumbhani, Assistant Professor of Internal Medicine at UT Southwestern Medical Center. "We found that, contrary to many older studies, there was a very weak association of hospital annual volumes with risk-adjusted outcomes for these procedures."
(Excerpt) Read more at news-medical.net ...
I had been waiting for about ten years for the technology to catch up. The surgery was performed on November 9. They sent two leads up through my groin, one with the valve and the other with a camera. They increased the heartbeat to a high level and then placed the new valve over the old one. The pacemaker high heartbeat caused a vacuum which sucked the new valve into place.
Technology is great!
Glad it helpped, but the cost savings at a rate of .014 over the other procedures is not very exciting. 7k out of 114k is hardly a major victory for the patient as the tone of the article try to imply.
This smacks of trying to squeeze justification from statistics like blood from a turnip to me.
If it truly was a breakthrough, you would not need such an extensive study to “prove “ it.
Good news! Prayers up.
Whatever happened to the Jarvik-7, or whatever that mechanical heart was called?
Problem is that with TAVR there is no chest cutting involved. I was out of the hospital in three days. I could not have survived another chest cutting.
And it is a major breakthrough. Pray that if you ever need it the technology will even be much more advanced.
Whatever happened to the Jarvik-7, or whatever that mechanical heart was called?
___________________________
Technology.
I had an S3 TAVR and went home the next morning. (St. Joseph’s Hospital in Orange, CA). Feeling great. Prior to the procedure my ejection fraction was 30-35% and now it is at 65%. God has truly blessed me with brilliant doctors.
I probably could also have gone early except for the damn influenza B that happened a week before the procedure. I think my EF will be greatly improved as well. 65% is fabulous!
Thank God for this technology
You take good care of yourself. Let me know what your new EF is. The surgical team told me that mine went to 55% immediately on the operating table after the valve was placed. May God bless you.
GOD is greater!
Glad you are still with us!!
But could this be translated into English for folks like me?
No room left for another zipper?
What’s EF?
EF is Ejection Fraction which concerns how efficiently the heart is circulating blood to the rest of the body. When the aortic valve is not opening and closing properly, it can’t pump the blood with enough force. Blood leaks in when not closed enough, and blood doesn’t make it out as well when it doesn’t open enough.
It’s funny, because I hate hospitals, but the lady in the next room in ICU who also had a TAVR the same day, beat me outta there the next day, practically running, until they forced her into the wheelchair for discharge.
Forgot to mention that 65-75% Ejection Fraction is the normal range. This might be a good time to issue a warning. Aortic stenosis means your aortic valve is calcified (calcium buildup) which means it can’t open and close properly. Most people never have a clue that it is happening and unless the doctor catches it, the person normally dies in 1-2 years. I was fortunate enough to have a Life Line Screening which revealed post ventricular contractions, which led to my doctor’s appointment, which led to my new cardiologist, etc. Get a Life Line Screening, it’s definitely worth it and is totally non-invasive.
I hope you were out of this during this procedure...yikes....
Problem is that with TAVR there is no chest cutting involved. I was out of the hospital in three days. I could not have survived another chest cutting.
And it is a major breakthrough. Pray that if you ever need it the technology will even be much more advanced.
...
I’m trying to get my bovine valve to last as long as possible so my next one can be done by catheter. It was implanted in 2012 and in 2015 I was told I already had severe stenosis (I could hear it and feel it under the right conditions) and would need surgery at the first sign of symptoms. I started taking vitamin K2 and the stenosis cleared up. My doctors won’t acknowledge it happened. My cardiologist even told me to stop taking the K2. You can imagine what I told him. I won that argument.
They were not planning on total however ended up that way.
Came close this time. And I prayed like crazy.
Today I was able to walk 100 yards.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.