Geographic and Demographic Variability in Transcatheter Aortic Valve Replacement Dispersion in the United States

Journal of the American Heart Association

Michael N Young, Stephen Kearing, David Malenka, Philip P Goodney, Jonathan Skinner, Alexander Iribarne

Background

Transcatheter aortic valve replacement (TAVR) has transformed the management of aortic valve stenosis. However, little national data are available characterizing the geographic and demographic dispersion of this disruptive technology relative to surgical aortic valve replacement (SAVR).

Methods and Results

In this US claims‐based study, we analyzed a 100% sample of fee‐for‐service Medicare beneficiaries from 2012 to 2017 and examined national rates of TAVR versus SAVR. Procedure rates were compared across years as a function of age, sex, race, and geography for TAVR and SAVR beneficiaries. There was significant growth in TAVR from 15.4 beneficiaries/100 000 enrollees in 2012 to 90.6 in 2017 (P<0.001). SAVR rates declined from 92.8 beneficiaries/100 000 enrollees in 2012 to 63.5 in 2017 (P<0.001). The growth of TAVR varied as a function of age (P<0.0001). While TAVR was the …

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