Percutaneous heart valves for valvular heart disease: an updated review of the clinical and cost-effectiveness and guidelines

Canadian Agency for Drugs and Technologies in Health
Record ID 32011001175
English
Authors' recommendations: This updated rapid review based on a search from December 2009 to April 2010 did not identify any evidence from randomized controlled trials of the comparative efficacy of TAVI and SAVR, which would help to better understand the clinical implications of TAVI. Patients who undergo TAVI are systematically different than patients who undergo SAVR since they are those patients not eligible for SAVR. This makes it difficult to draw conclusions about the comparative efficacy of the two surgical techniques. Results from a HTA report suggest that the expected 30-day mortality rate following TAVI is 8 to 10%. Based on data from observational studies, TAVI appeared to be less likely to cause acute kidney injury than SAVR. One study suggested that that TAVI could be associated with either substantial benefits or harms, relative to SAVR. A third study found that TAVI was associated with foci of restricted diffusion on MRI, but not with neurological deficits. No conclusions about the cost-effectiveness and guidelines for use of percutaneous heart valves could be made from the identified literature. These conclusions are similar to those of the previous rapid review that concluded that the safety and efficacy of percutaneous heart valve replacement were largely unknown, due to methodological limitations of the identified literature including study design, lack of long-term clinical data, and lack of economic data.
Details
Project Status: Completed
Year Published: 2010
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Cost-Benefit Analysis
  • Heart Valve Diseases
  • Treatment Outcome
Contact
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name: requests@cadth.ca
Contact Email: requests@cadth.ca
Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.