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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

MALUENDA, Gabriel et al. Cost-Effectiveness of Trans Aortic Valve Replacement vs. Conservative Treatment in High-risk Patients with Severe Aortic Stenosis in a Referral Hospital Center in Santiago, Chile. Rev Chil Cardiol [online]. 2015, vol.34, n.1, pp.11-17. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602015000100001.

Aim: to evaluate cost-effectiveness of Transcatheter Aortic Valve Replacement (TAVR) compared to conservative treatment in patients with very high risk severe aortic stenosis (AS) referred to a tertiary center in Santiago, Chile Methods: Patients with high surgical risk and severe AS referred between January 2013 and September 2014 were included. Cost of resources, readdmissions, life-years gained and incremental cost-effectiveness of TAVI were calculated Results: Thirty-nine patients were finally included. Mean age was 82±7 years old, more commonly women (74%) with a mean STS score of 11.4±5.6 that confirmed their high-risk. Seventeen patients (43.6%) had TAVR and 22 (56.4%) underwent conventional medical therapy. All patients in the TAVR group - treated with Sapien XT® device - survived the procedure and were discharged alive. Mean cost of the procedure was approximately US$ 33,500. After a mean follow-up period of 285±204 days, mean survival rate in the control group was 54.5% (10 deaths) as compared to 94.1% in the TAVR group (1 death, p<0.001). Therefore, a gain of al least one year was obtained with TAVR resulting in an incremental cost effectiveness of US$ 26.470 per year of life gained. Conclusion: TAVR resulted costly-effective compared to conventional therapy in patients with severe AS and high surgical risk in a Chilean referral center.

Palabras clave : cost effectiveness; transcatheter aortic valve replacement; aortic stenosis.

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