Impact of Transcatheter Aortic Valve Replacement on Surgical Volumes and Outcomes in a Tertiary Academic Cardiac Surgical Practice

Annual number of candidates for transcatheter aortic valve implantation per country: current estimates and future projections

“…The annual number of TAVI procedures has been growing since its introduction, while at the same time the number of annual SAVR procedures remained more or less unchanged, or even increased. [26][27][28] However, now TAVI has been demonstrated to be non-inferior to SAVR in intermediate-risk patients this trend is changing and in some countries, annual TAVI numbers are exceeding the number of isolated SAVRs. [8][9][10][11][12]29,30 Ongoing randomized-controlled trials are investigating TAVI in the low-risk group (PARTNER 3, NOTION-2, Medtronic Transcatheter Aortic Valve Replacement in Low Risk Patients; clinicaltrials.gov identifiers: NCT02675114, NCT02825134, and NCT02701283, respectively).…”

Implementation of transcatheter aortic valve replacement in California: Influence on aortic valve surgery

“…Overall volume increase of aortic valve replacements in both surgical and nonsurgical groups was attributed to the inclusion of high-risk patients who may not have been evaluated before TAVR program initiation. 14 Brennan and colleagues 15 also showed similar results, finding that overall SAVR increased by 16% in non-TAVR hospitals compared with 22% increases in hospitals with TAVR programs from 2008 to 2013. Other studies have also shown increases in SAVR volume with initiation of TAVR programs.…”

The Outcomes for Different Biological Heart Valve Prostheses in Surgical Aortic Valve Replacement before and after the Introduction of Transcatheter Aortic Valve Implantation

“…Referral for TAVI is automatically the case for octogenarians in some institutions [16]. The currently documented increase in the use of SAVR was also observed in several other series [12,[17][18][19][20][21][22][23][24][25][26][27][28]. This increase in number was observed in older as well as in younger patients [2,29].…”

“…In one series [32], the volume increased only in hospitals that did not perform TAVI. The volume of SAVR did not change significantly in several other series [16,19,33,34], while the volume was reduced in another five series [35][36][37][38][39]. In one recent series, the number of patients referred for SAVR decreased in all age groups (<65 years, 65-80 years, <80 years) between 2016 and 2019, while at the same time the use of TAVI increased for these same age groups.…”

“…However, the association of CABG did not increase over time in the current series. In most earlier series, only i-SAVR was investigated, which precludes any statement on changes in the complexity [18][19][20]24,25,[32][33][34]36,37,[40][41][42]44,46,49]. In elderly or high-risk patients for whom SAVR with associated CABG could be considered, TAVI combined with PCI could be an alternative.…”