The Post Standard has a report on a minimally invasive heart valve procedure that is saving lives of patients with aortic valve stenosis who are not physically strong enough to undergo open heart surgery. Transcatheter aortic health valve replacement (TAVR) is relatively new here in the United States, but has been done in Europe for quite a while now. It involves snaking a tube holding a collapsible replacement heart valve through the arteries to the heart. Instead of a 6 week or longer recovery time most patients who undergo TAVR recover in a matter of days.
You would think something like this would replace open heart surgery for valve replacement, but alas, you’d be wrong.
Dr. Matthew O’Hern, an interventional cardiologist at St. Joe’s, said TAVR has the potential to eventually replace traditional valve surgery because it is so much easier on patients. It can take six weeks to recover from open heart surgery versus three days from TAVR. “If you look at how people feel after 30 days, TAVR blows away surgery,” he said.
The procedure was first performed 10 years ago in France. Since then it has grown rapidly in Europe, where more than 40,000 of the procedures have been done. In Europe the procedure is being offered to many patients who are suitable for surgery. That has sparked criticism from some medical researchers who say TAVR is being overused in Europe and is not cost effective in patients who can undergo surgery.
A TAVR valve costs $32,000, about six times more than a valve used in traditional surgery.
U.S. regulators want to prevent TAVR from expanding too quickly here, O’Hern said. It is only approved in the United States for patients considered inoperable because of their age or because they have lung disease, kidney disease, a history of heart attacks or other risk factors.
It will probably not become available to other patients who need valve replacements until more studies are done on long-term outcomes among people who get TAVR and the cost of the valve comes down, O’Hern said.
A valve made by Edwards Lifesciences is the only TAVR valve approved for use in the United States.
“We need competition,” O’Hern said. (Read More)
Ah, competition, the thing that brings prices down and makes things more affordable. Well, with Obamacare and all of the other federal regulations don’t expect to see much competition any time soon. But at least there’s an option for those who really need it, at least for now. Who knows if the IPAB will decide that none of these procedures are cost effective and therefore will no longer be available to anyone.