Clinical Outcome of TAVR vs. SAVR in Patients With Cardiac Amyloidosis

Khan, Muhammad Zubair; Brailovsky, Yevgeniy; Vishnevsky, O. V.; Baqi, Abdul; Patel, Kirtenkumar; Alvarez, René

doi:10.1016/j.carrev.2022.04.027

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…In addition to bundle branch block, cardiac amyloidosis should also be considered with patients undergoing aortic valve replacement. Khan’s study compared TAVR and SAVR in patients with cardiac amyloidosis [ 25 ]. The presence of cardiac amyloidosis is shown to have a significantly worse outcome than those without cardiac amyloidosis [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…Khan’s study compared TAVR and SAVR in patients with cardiac amyloidosis [ 25 ]. The presence of cardiac amyloidosis is shown to have a significantly worse outcome than those without cardiac amyloidosis [ 25 ]. Previous studies have shown that TAVR yielded a better outcome in aortic stenosis-cardiac amyloidosis patients than medical therapy [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…The presence of cardiac amyloidosis is shown to have a significantly worse outcome than those without cardiac amyloidosis [ 25 ]. Previous studies have shown that TAVR yielded a better outcome in aortic stenosis-cardiac amyloidosis patients than medical therapy [ 25 ]. This study shows, after adjustments for confounding factors, that the SAVR group has higher mortality and cost, while the LOS was shorter for the TAVR group, as we may have predicted [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…Previous studies have shown that TAVR yielded a better outcome in aortic stenosis-cardiac amyloidosis patients than medical therapy [ 25 ]. This study shows, after adjustments for confounding factors, that the SAVR group has higher mortality and cost, while the LOS was shorter for the TAVR group, as we may have predicted [ 25 ]. TAVR and SAVR each yield slightly different rates for complications [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…TAVR and SAVR each yield slightly different rates for complications [ 25 ]. Patients in the TAVR group are more likely to develop stroke, vascular complication, and permanent pacemaker implantation, while the patients in the SAVR group were more prone to develop acute myocardial infarction, acute kidney injury, and major bleeding, which is reasonable due to the more invasive nature of SAVR [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

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Transcatheter Aortic Valve Replacement (TAVR) Versus Surgical Aortic Valve Replacement (SAVR): A Review on the Length of Stay, Cost, Comorbidities, and Procedural Complications

Kermanshahchi,

Thind,

Davoodpour

et al. 2024

Cureus

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This review provides an in-depth analysis of the effect of length of stay (LOS), comorbidities, and procedural complications on the cost-effectiveness of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR). We found that the average LOS was shorter for patients undergoing TAVR, contributing to lower average costs associated with the procedure, although the LOS varied between patients due to the severity of illness and comorbidities present. TAVR has also been found to improve the quality of life for patients receiving aortic valve replacement compared to SAVR. Although TAVR has a lower rate of most post-operative complications caused by SAVR, such as bleeding and cardiac complications, TAVR shows an increased rate of permanent pacemaker (PPM) implantation due to mechanical trauma on the heart’s conduction system. In addition, our findings suggest that the cost-effectiveness of each procedure varies based on the types of valve, the patient history of other medical conditions, and the procedural methods. Our findings show that TAVR is preferred over SAVR in terms of cost-effectiveness across a variety of patients with other coexisting medical conditions, including cancer, advanced kidney disease, cirrhosis, diabetes mellitus, and bundle branch block. TAVR also appears to be superior to SAVR with fewer post-operative complications. However, TAVR appears to have a higher rate of PPM implantation rates as compared to SAVR. The comorbidities of the valve recipient must be considered when deciding whether to use TAVR or SAVR as cost-effectiveness varies with the patient background.

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Section: Reviewmentioning

confidence: 99%