Is transcatheter aortic valve implantation cost effective in the nonsurgical elderly population?

Transcatheter aortic valve implantation (TAVI) is an effective treatment for patients with aortic stenosis who are considered to be unsuitable for aortic valve replacement (inoperable). Inoperability is determined by the heart team, which includes a cardiac surgeon. TAVI in these patients has been shown to improve survival and symptoms when compared with standard therapy; however, TAVI comes at an increased cost. Six studies have calculated incremental cost-effectiveness ratios for TAVI in the inoperable patient and results have been varied. Moreover, incremental cost-effectiveness ratios were calculated from trial data, which may not reflect real-world experience. TAVI may only be marginally cost effective in inoperable patients with aortic stenosis.