69,000 Transcatheter Aortic Valve Replacements from 2013-2017; 60,000 Used Zooplastic Tissue


In Heart Failure

By: James Pitt  Aug. 27, 2018

Transcatheter aortic valve replacement (TAVR, aka TAVI or PAVR) is a procedure to replace the valve between the largest blood vessel and the heart. In this procedure, a replacement valve is passed along through a blood vessel to the heart. This allows surgeons to replace the valve in patients who would face too many risks in open-heart surgery.

Untreated, candidates for aortic valve replacement would have “an average survival of only 2 to 3 years”, while surgery returns life expectancy to near-normal. In March 2018, interim results from the NOTION clinical trial showed “no differences in all-cause mortality, stroke or myocardial infarction” between TAVR and surgery in low-risk patients at five years. University of Michigan cardiac surgeon G. Michael Deeb predicted TAVR will become more commonly used than surgery for aortic disease, if the results in low-surgical-risk patients hold up.

There are also a number of adjunctive products for TAVR, such as cerebral embolic protection devices. TAVR has a risk of stroke; a September 2017 clinical trial found that cerebral embolic protection with the Claret Medical Sentinel device was associated with a reduction in stroke rate from 4.6% to 1.4% and reduction in mortality from 6.8% to 2.1% within seven days of TAVR.

To examine the market for aortic valve replacements and adjunctive products, Dexur examined CMS inpatient discharge data from 2013-2017. In this period, about 69,588 CMS discharges had percutaneous aortic valve replacement (i.e. TAVR) as a primary or secondary procedure code. CMS classifies valve replacement procedures by the type of valve used and surgical approach. Zooplastic tissue and a simple percutaneous approach (i.e. femoral rather than transapical) were by far the most popular.

Zooplastic Tissue Dominates Aortic Valve Replacements

DEXUR PRO MEMBERS GET ACCESS TO:

  1. Procedure Code
  2. Procedure Description
  3. Total National Projected Hospitalizations - (Present on Admission - All)
  4. Total Medicare Hospitalizations - Jan 2013 to Dec 2017 (Present on Admission - All)
  5. Total Medicare Hospitalization after Exclusion
  6. Avg. LOS
  7. Readmission Rate (%)
  8. Unplanned Readmission Rate (%)
  9. Total Medicare Payments
  10. Payment Per Day
  11. Payment Per Discharge
  12. Total Medicare Charges
  13. Avg. Charges
  14. Mortality Rate (%)
  15. SNF Discharge Rate (%)
  16. Home Discharge Rate (%)

In CMS inpatients nationwide from 2013-2017, for the following ICD-10-PCS procedure codes:

  1. 02RF37 - Autologous Tissue Substitute - as a primary procedure code
  2. 02RF37 - Autologous Tissue Substitute - as a primary procedure code
  3. 02RF37 - Autologous Tissue Substitute - as a primary or secondary procedure code
  4. 02RF37 - Autologous Tissue Substitute - as a primary or secondary procedure code
  5. 02RF38 - Zooplastic Tissue - as a primary procedure code
  6. 02RF38 - Zooplastic Tissue - as a primary procedure code
  7. 02RF38 - Zooplastic Tissue - as a primary or secondary procedure code
  8. 02RF38 - Zooplastic Tissue - as a primary or secondary procedure code
  9. 02RF3J - Synthetic Substitute - as a primary procedure code
  10. 02RF3J - Synthetic Substitute - as a primary procedure code
  11. 02RF3J - Synthetic Substitute - as a primary or secondary procedure code
  12. 02RF3J - Synthetic Substitute - as a primary or secondary procedure code
  13. 02RF3K - Nonautologous Tissue Substitute - as a primary procedure code
  14. 02RF3K - Nonautologous Tissue Substitute - as a primary procedure code
  15. 02RF3K - Nonautologous Tissue Substitute - as a primary or secondary procedure code
  16. 02RF3K - Nonautologous Tissue Substitute - as a primary or secondary procedure code
  17. 02RF47 - Autologous Tissue Substitute - as a primary procedure code
  18. 02RF47 - Autologous Tissue Substitute - as a primary or secondary procedure code
  19. 02RF48 - Zooplastic Tissue - as a primary procedure code
  20. 02RF48 - Zooplastic Tissue - as a primary or secondary procedure code
  21. 02RF4J - Synthetic Substitute - as a primary procedure code
  22. 02RF4J - Synthetic Substitute - as a primary or secondary procedure code
  23. 02RF4K - Nonautologous Tissue Substitute - as a primary procedure code
  24. 02RF4K - Nonautologous Tissue Substitute - as a primary or secondary procedure code

ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.