Related Experiment Video

Updated: Sep 10, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:02

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

177

Incremental Cost and Length of Stay Associated With Complications of Transcatheter Aortic Valve Replacement

Steven D Culler1, Matthew R Reynolds2, Aaron D Kugelmass3

  • 1Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

JACC. Advances
|August 27, 2025
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) complications significantly increase hospital costs by over $12,000 per patient. Mitigating these adverse events in TAVR procedures offers substantial cost savings.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Medical Device Technology

Background:

  • Transcatheter aortic valve replacement (TAVR) is the leading procedure for aortic valve replacement, with nearly 100,000 annual US procedures.
  • The economic impact of TAVR complications on hospital resource utilization remains incompletely understood.

Purpose of the Study:

  • To quantify the additional hospital resource use and associated costs linked to TAVR complications.
  • To analyze the financial burden imposed by adverse events following TAVR procedures.

Main Methods:

  • Utilized the 2020 Medicare Provider Analysis and Review file for 66,893 TAVR beneficiaries.
  • Employed ICD-10-CM codes to identify complications and cost-to-charge ratios for hospital cost calculation.
  • Applied multivariable regression to estimate incremental costs and length of stay (LOS) associated with complications.

Main Results:

  • In 2020, 31.1% of Medicare TAVR patients experienced complications, increasing mean hospitalization costs by $15,377 and LOS by 2.8 days.
  • Risk-adjusted incremental cost of complications was $12,953, with surgical aortic valve replacement, dialysis-requiring renal failure, and in-hospital mortality being the most costly.
  • Complications contributed $320 million in additional costs, representing 8.7% of total Medicare TAVR hospital expenditures.

Conclusions:

  • Approximately one in three Medicare TAVR patients encounter serious complications, significantly elevating hospital resource use.
  • Despite TAVR advancements, substantial cost savings are achievable through focused efforts on complication reduction and mitigation strategies.
Abstract

Keywords:
aortic stenosiscomplicationscosttranscatheter aortic valve replacement

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