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Updated: Feb 21, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
The cost of transcatheter aortic valve implantation according to different access routes
Eliana Bittar1, Valéria Castilho2
1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Objective:
Identifying the average direct cost of TAVI (Transcatheter Aortic Valve Implantation) for the different access routes.
Method:
This is a research with a quantitative, exploratory and descriptive approach carried out in a government teaching hospital in the state of São Paulo.
Results:
The average direct cost of TAVI procedures by the access routes resulted in R$82,826.38 (transfemoral route), R$79,440.91 (transaortic route) and R$78,173.41 (transapical route). The transcatheter valve cost represented a percentage variation between 78.47% and 83.14% of the total cost of the procedure. The Kruskal-Wallis test was used and presented a statistically significant difference between the three access routes: p=0.008. The Bonferroni test showed a difference in the association between transfemoral and transapical routes, while no statistically significant difference was observed in association with the transaortic route.
Conclusion:
The results are important for formulating adequate funding policies for the hospital network and understanding the costs according to the route facilitates rationalizing resources in order for them to be guaranteed for patients who present surgical contraindication to the valve implant.
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