The Contemporary article trends in the management of aortic stenosis in the USA was published in the European Heart Journal in 2020. This study documents current trends in the inpatient treatment of aortic stenosis (AS) in the USA. Several studies have demonstrated a nationwide increase in TAVI volume and continuous improvement in its results over the past few years. This study evaluated current trends in AS interventions and associated costs, resource use, and differences in the US. It was found that data on current trends in interventions for AS in the United States remains reduced.
Advances in transcatheter aortic valve surgery have dramatically changed the management of severe AS worldwide, particularly in the United States. The availability of transcatheter aortic valve implantation (TAVI) has expanded the therapy of many previously undertreated patients and has affected the volume and risk profile of patients undergoing aortic surgery (Alkhouli et al., 2020). It has also spurred an unprecedented amount of research to optimize the treatment of this widespread disease.
Between 2003 and 2016, 835,750 aortic valve replacements/implantations were performed in the United States. The share of TAVI among all valve replacement surgeries increased markedly from 11.9% in 2012 to 43.2% in 2016 (Alkhouli et al., 2020). The cost of isolated Surgical aortic valve replacement (SAVR) and TAVI hospitalizations also decreased significantly over time, but TAVI hospitalizations remained more expensive than isolated hospitalizations with SAVR. This study of temporal trends in AS treatment in the United States documented a significant paradigm shift in the type of valve replacement procedure. Although most resource utilization parameters have decreased for both SAVR and TAVI, this study shows an essential advantage of TAVI in current practice. However, the incidence of postoperative stroke did not reduce significantly.
Alkhouli, M., Alqahtani, F., Ziada, K. M., Aljohani, S., Holmes, D. R., & Mathew, V. (2020). Contemporary trends in the management of aortic stenosis in the USA. European Heart Journal, 41(8), 921–928. Web.